URORADIOLOGY
Case 15 :
65 year old male, a known case of chronic ischaemic heart disease, presents with abdominal distension and left flank pain. What is the diagnosis?
Click here for bigger picture
Click here for bigger picture
Click here for bigger picture
Fig 1
Fig 2
Fig 3
__________SCROLL FOR ANSWER__________






Imaging Diagnosis

Spontaneous retroperitoneal (psoas) hematoma.

Discussion


In a patient on oral anticoagulation with sudden onset of loin pain, the possibility of spontaneous bleeding in the retroperitoneum must be considered in the differential diagnosis of renal colic. This rare pathology can be life-threatening, and rapid diagnosis with ultrasound and computerized tomography of the abdomen must be made. If the patient is hemodynamically stable, a conservative approach is justified. Otherwise, emergency surgery may be needed.

Dr. JP Jadwani, Mumbai