Background: Spontaneous intramuscular haematomas by definition are haematomas without known etiology and exclude those caused by trauma, surgery, and muscular disease. This is a rare condition which has been increasing in incidence lately largely due to anticoagulant therapy use and currently, there is no level 1 evidence with regards to the best management of these patients, with different institutions using different approaches to treatment.
Materials and methods: We retrospectively analyzed 31 patients who were treated with the diagnosis of spontaneous intramuscular haematoma in our center, in the years between 2013 and 2017. Patient information was recorded including patient characteristics, vital parameters, biochemical data, imaging data, risk stratification scores, and patient outcomes.
Results: We observed that on average males had longer hospitalizations and a higher baseline platelet count was a protective factor against haemorrhage. On temporal evaluation of haemoglobin levels, we saw an important drop of haemoglobin at T6 for the transfused patients. The majority of patients (61.29%) were treated with arterial embolization, with great technical and clinical success (94% and 81% respectively). There was also a very strong association between patients treated with non-operative therapy (NOT) and shorter hospitalization.
Conclusion: NOT and embolization therapy are very effective treatments for spontaneous haematomas in the appropriate patient and should be included in the protocol. The small sample size was a very large limitation for the study, and a multicentric study is needed to further strengthen any associations we saw between risk factors and outcomes. We propose the need to perform a prospective study to ascertain the appropriate follow-up times for such investigations.
