Late retroperitoneal haematoma after psoas compartment block for total hip arthroplasty

Objective: Post-operative anemia may be a compelling problem, sometimes sudden, of difficult diagnosis, that may be enhanced by underlying medical conditions, and that may influence therapeutic choices. Case report: We present a case of sudden anemia (from 10.2 pt. to 7.3 pt. of HB in two days), after a total hip arthroplasty, performed under combined spinal and peripheral anesthesia, in a 70 years old woman who suffered from a coagulation disorder due to a rare genetic mutation (homozygosis for MTHFR C677T). Conclusion: The anaemia was due to retroperitoneal hematoma with a pseudo aneurysm of the left lumbar artery, with active bleeding localized at L4, resolved by intervention of intravascular remobilization of the feeder artery of the pseudo aneurysm