Spontaneous Iliopsoas Hematoma- a Bloody Masquerader

Retroperitoneal hemorrhage represents one of the rare yet devastating complications that may arise in patients undergoing anticoagulation therapy, with contributing factors commonly including advanced age, trauma—particularly associated with sports injuries—and underlying bleeding diatheses. Together with intracranial hemorrhages, these instances account for approximately 4% of all such cases. Given the diverse symptomatology associated with this condition, timely diagnosis is essential, necessitating immediate triage and a structured treatment approach. A CT angiogram is typically the preferred diagnostic modality in instances where abdominal ultrasound fails to provide clarity. The optimal management strategy for retroperitoneal hemorrhage remains a subject of ongoing debate. In this report, we present a case of spontaneous iliopsoas hematoma occurring in an adult without any identifiable predisposing factors—an unprecedented instance with no prior documentation in the relevant literature.