HEMATOMA OF THE PSOAS MUSCLE IN A PATIENT ON ANTICOAGULANTS: CASE REPORT

Psoas hematoma is one of the most serious complications of anticoagulant therapy. It occurs mainly in patients treated with Heparin or Warfarin, either in cases of overdose or even during properly managed treatment. Clinically, it presents with intense pain, muscle paralysis, and sensorimotor deficits along the course of the femoral nerve, which are difficult to identify in intensive care patients. Treatment is mainly conservative; surgical management has specific indications and requires correction of hemostasis disorders, which justifies the use of percutaneous drainage. Managing anticoagulants or deciding whether to continue them in such situations is a therapeutic challenge. We report the case of a 78-year-old patient admitted for management of a head injury, anticoagulated for a pulmonary embolism, who developed a vitamin K antagonist (VKA) overdose with a psoas hematoma during hospitalization.