ABSTRACT
Resumen El uso de tromboprofilaxis posterior a las cirugías cervicales es una práctica recomendada a nivel mundial debido a que este tipo de pacientes presentan un mayor riesgo de desarrollar tromboembolismos venoso. Dentro de los efectos adversos de esta terapia se ha descrito la epistaxis, hematuria, formación de hematomas y sangrados. El hematoma espontáneo del músculo psoas iliaco, se considera una entidad poco frecuente, que suele asociarse a alteraciones de la coagulación, hemofilia o discrasias sanguíneas y como terapia anticoagulante, siendo este último la principal causa. En la autopsia médico legal, el hematoma del músculo psoas iliaco, suele ser un hallazgo incidental y en la mayoría de casos no contribuye en la causa de muerte. En el presente artículo se expone el caso de un masculino conocido con una enfermedad renal crónica, el cual desarrolló un hematoma espontáneo del músculo psoas iliaco, secundario al uso de enoxaparina como tromboprofilaxis posterior a una intervención quirúrgica en el cuello, que lo condujo a un shock mixto ocasionándole la muerte.
Abstract The use of thromboprophylaxis after cervical surgeries is a recommended practice worldwide due to the fact that these types of patients have a higher risk of developing venous thromboembolisms. Among the adverse effects of this therapy it has been described epistaxis, hematuria, formation of hematomas and bleeding. Spontaneous hematoma of the iliac psoas muscle is considered a rare entity, which is usually associated with coagulation disorders, hemophilia or blood dyscrasias and anticoagulant therapy, the latter being the main cause. In the medico-legal autopsy, the hematoma of the iliopsoas muscle is usually an incidental finding and in most cases does not contribute to the cause of death. This article describes the case of a male known with chronic kidney disease, who developed a spontaneous hematoma of the iliac psoas muscle, secondary to the use of enoxaparin as thromboprophylaxis after a surgical intervention in the neck, which led to a mixed shock causing death.
Subject(s)
Humans , Male , Psoas Muscles/pathology , Hematoma , Renal Insufficiency, Chronic , AnticoagulantsABSTRACT
El absceso de músculo psoas iliaco se considera una rare-za. Su detección ha mejorado con la utilización de imágenes como la tomografía computada o la resonancia magnética. Presentamos una revisión de casos de absceso de psoas-iliaco internados entre julio de 2015 y febrero de 2018 en un hospital de CABA, Argentina.En este periodo se diagnosticaron un paciente conside-rado de origen primario y ocho de origen secundario. Se observó predominio de colecciones asociadas a es-pondilodiscitis. El síntoma más frecuente fue la fiebre. Staphylococcus aureus fue el germen más rescatado en muestras microbiológicas. Se debe tener alto índice de sospecha de esta patología ante la presencia de fiebre, dolor lumbar y en ocasiones alteración de la marcha. El empleo de antibióticos de amplio espectro sumado a la evacuación de colecciones constituyen la estrategia más efectiva
Psoas-iliac muscle abscess is considered a rarity, the use of images such as computed tomography or magnetic reso-nance imaging has improved its detection.This study reviews cases of psoas-iliac abscess in hospi-talized patients between July 2015 and February 2018 in a hospital in CABA, Argentina.In one of the patients the origin was considered primary ,while in the other eight it was secondary. There was a pre-dominance of collections associated with spondylodiscitis. The most frequent symptom was fever. Staphylococcus au-reus was the most frequent organism obtained in microbio-logical samples. A high level of suspicion must be held in the presence of fever, lumbar pain and sometimes alteration of the gait. The use of broad spectrum antibiotics in addition to evacuation of collections is the most effective strategy.
Subject(s)
Humans , Adult , Middle Aged , Aged , Staphylococcal Infections/therapy , Psoas Muscles/pathology , Psoas Abscess/diagnosis , Psoas Abscess/etiology , Psoas Abscess/therapy , Methicillin-Resistant Staphylococcus aureus , Anti-Bacterial Agents/therapeutic useABSTRACT
We describe a case of a 54-yr-old AL amyloidosis patient who developed femoral compressive neuropathy due to iliopsoas pseudohypertrophy. The patient, who presented with end stage renal disease, was referred to our clinic because of lower extremity weakness and polyarthritis. Finally, he was diagnosed as having kappa-AL amyloidosis, complicated by femoral compressive neuropathy, hypertrophic amyloid myopathy, amyloid arthropathy, carpal tunnel syndrome, and end stage renal disease. Femoral compressive neuropathy has never been reported in association with amyloid induced iliopsoas hypertrophic myopathy. This report expands the clinical spectrum of AL amyloidosis.
Subject(s)
Humans , Male , Middle Aged , Amyloidosis/pathology , Fatal Outcome , Femoral Neuropathy/pathology , Hypertrophy , Kidney Failure, Chronic/pathology , Nerve Compression Syndromes/pathology , Psoas Muscles/pathologySubject(s)
Humans , Female , Middle Aged , Accidental Falls , Bursitis , Psoas Muscles/pathology , Bursitis , Physical Therapy Specialty , Spinal PunctureABSTRACT
Este trabalho tem como objetivo revisar as patologias que acometem o compartimento iliopsoas. Foi realizada análise retrospectiva de casos com acometimento do compartimento iliopsoas avaliados por tomografia computadorizada (TC), no Departamento de Radiologia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas, nos últimos dez anos, confirmados por biópsia cirúrgica ou percutânea. Os principais diagnósticos encontrados foram neoplasias, abscessos e hematomas. Os achados tomográficos baseiam-se na extensäo do acometimento iliopsoas, no grau de atenuaçäo, margens de lesäo, presença de gás e/ou calcificações, destruição óssea, infiltração da gordura e acometimento de estruturas abdominais adjacentes. A TC é o método de escolha na avaliação do compartimento iliopsoas, podendo ser utilizada para orientar biópsias percutâneas, cirúrgicas ou drenagem. Porém, os achados isolados do estudo por TC, sem o conhecimento da história clínica, não são específicos para permitir a diferenciação das diversas patologias que acometem o compartimento iliopsoas.
Subject(s)
Humans , Psoas Muscles/pathology , Diagnosis, Differential , Tomography, X-Ray ComputedABSTRACT
La bursitis iliopsoas es una alteración infrecuente generalmente asociada a patología de la articulación coxo-femoral, donde la artritis reumatoidea y la enfermedad degenerativa articular son las enfermedades de base observadas con mayor frecuencia. Se presenta un caso atípico de bursitis iliopsoas que motivó deferentes diagnósticos diferenciales teniendo en cuenta los antecedentes y las manifestaciones clínicas del paciente. El diagnóstico fue establecido por las características imagenológicas, por tomografía computada de la lesión y confirmado mediante una punción-aspiración de la misma. Se completa la presentación con una actualización del tema
Subject(s)
Humans , Male , Aged , Bursitis/diagnosis , Psoas Muscles , Hip Joint , Bursitis/etiology , Diagnosis, Differential , Magnetic Resonance Imaging , Psoas Muscles/pathology , Punctures , Magnetic Resonance Spectroscopy , Spinal Puncture , Tomography, X-Ray ComputedABSTRACT
About 8 cases of primary psoas abscess that have been treated surgically in our department since 1990, and after reviewing literature, we emphasizing the rarity of this entity, the difficult and late diagnosis because of simulation with other aflections [arthritis of the hip, appendicitis.].The etiology of primary psoas absess remains speculative. A post traumatic hematoma within the psoas muscle secondarily infected by hematological transmission from a pre-existing focus on the skin, secms to be the most likely etiology. Percutaneous guided catheter drainage has changed the therapeutic approach to psoas abcesses. It represents the best alternative to surgery of this disease