Psoas Hematoma: Definition and Management

psoas hematoma is a condition that results from the accumulation of blood in the psoas muscle. This can cause pain and swelling in the affected area.


In most cases, the psoas hematoma resolves on its own, but in some cases surgery may be required. In this blog post, we are going to discuss the definition ofpsoas hematoma, as well as treatment options for this condition.

What is a psoas hematoma?


THEpsoas hematoma is a type of hematoma that occurs in the iliopsoas muscle. This muscle is found in the lower part of the abdomen and helps to flex the hip. Psoas hematomas are relatively rare and occur in only 0,1-0,6% of patients.


They can be caused by a number of factors, including trauma, blood thinning therapy, and certain types of cancer. In some rare cases, coughing or vomiting may trigger a psoas hematoma.


Psoas hematomas can cause pain and tenderness in the lower abdomen, as well as difficulty bending the hip. If left untreated, they can lead to serious complications, such as necrosis or muscle rupture.


The psoas hematoma must be diagnosed early so that appropriate treatment can be instituted.



But what is the psoas muscle?


Le psoas muscle is a rather thick and elongated muscle, consisting of two bellies muscle : the psoas major and the iliac, which join distally to insert at the level of the lesser trochanter of the femur.



psoas anatomy


The psoas is a fusiform muscle that originates on the first four vertebrae lumbar and the last vertebrate thoracic, as well as on the intervertebral discs intermediaries. The muscle then runs downward along the lateral aspect of the vertebral bodies and external foramina, until it reaches the basin.


The main function of the psoas is the flexion of the hip, which it accomplishes by acting on the femur. It also serves to stabilize the lumbar spine and works in synergy with other muscles to control trunk movements.


This is an important muscle for walking, running, and other activities that require hip movement.



Causes of Psoas Hematoma


psoas hematoma can have many causes, including trauma, anticoagulant therapy, and certain types of cancer. Psoas hematomas can also be caused by coughing or vomiting.


Any activity that puts pressure on the psoas muscle can be the origin of a hematoma. Risk factors for psoas hematoma include:


  • A hip or leg injury
  • Taking blood-thinning medications, such as heparin or warfarin;
  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs);
  • Certain types of cancer, such as breast cancer or prostate cancer;
  • Cough or vomiting.





psoas hematoma is most often diagnosed using a combination of methods, including a physical exam and diagnostic tests.


A doctor may suspect a hematoma psoas based on the patient's symptoms, which may include pain in the lower back or abdomen and difficulty flexing the hip or the knee. The hematoma of psoas can also be diagnosed using:




  • A radiograph ;
  • An MRI, which is a more sensitive test than an x-ray and may also show blood pooling in the muscle psoas;
  • A blood test, which may reveal abnormal blood clotting.



Consequences and clinical manifestation


THEpsoas hematoma, also known as haemorrhage of the psoas, is a serious condition that can have a number of negative consequences. If not treated quickly, psoas bleeding can lead to kidney failure, sepsis, and even death.


The most common symptom of a bleeding du psoas is severe pain in the lower back and abdomen. Other symptoms may include nausea, vomiting, and fever.


stomach ache representing visceral pain


The diagnosis of a hemorrhage du psoas is based on a combination of medical history, physical exams and imaging tests.


Treatment usually involves surgery to repair the damaged blood vessel and stop the bleeding. In some cases, a blood transfusion may also be necessary.


With prompt treatment, the prognosis of patients with a psoas bleeding is generally good.


However, complications can occur in some cases, so it is important to see a doctor as soon as possible if you have symptoms suggestive of a psoas hematoma.




Un psoas hematoma is a affection which, depending on its severity, requires treatment. Most hematomas of the psoas resolve spontaneously and do not require treatment.


However, if the thigh nerve is affected, surgical treatment is necessary to evacuate the hematoma and eliminate compression of the nerve. This can be done by percutaneous drainage, making sure there are no problems with blood circulation.




If treatment is delayed or ignored, the neurological consequences can be permanent. A symptomatic analgesic treatment can however be put in place if the volume of hematoma allows resolution without surgery.


It should be remembered that a hematoma of the iliopsoas muscle occurring in an elderly patient usually results in more severe symptoms.


Since thehematoma of psoas can have serious consequences if left untreated, it is important that you see your doctor for proper diagnosis and treatment.


Your doctor may prescribe medication to relieve pain and inflammation, as well as antibiotics if you have an infection. In case of bleeding or complications, surgery may be needed to remove the blood pooling.

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