{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:25:18Z","timestamp":1787117118144,"version":"build-2736575974"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Spontaneous large intermuscular hematoma secondary to mixed connective tissue disease (MCTD) is extremely rare. We report a 57-year-old female with long-standing MCTD admitted for abdominal pain and fever (septic shock due to E. coli pyelonephritis). On hospital day 8, she developed a left thigh hematoma (10\u2009\u2009\u00d7\u2009\u200914\u2005cm). CTA failed to identify the bleeding vessel, but transcatheter arterial embolization (TAE) stabilized the hematoma. Subsequent surgical debridement was performed for hematoma-induced tissue necrosis. This case highlights that MCTD-related vascular fragility, combined with sepsis and DIC, increases hematoma risk. Prompt TAE and surgical intervention are critical to prevent catastrophic outcomes.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1719697","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T04:40:28Z","timestamp":1787114428000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous intermuscular hematoma in mixed connective tissue disease: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhaohua","family":"Pei","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang Province, China"]},{"name":"Department of Emergency Medicine, The First People's Hospital of Hangzhou Lin'an District","place":["Hangzhou, Zhejiang Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Practice, The First People's Hospital of Hangzhou Lin'an District","place":["Hangzhou, Zhejiang Province, China"]},{"name":"Department of General Practice, Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Affliated Hangzhou First People's Hospital, School of Medicine, Westlake University","place":["Hangzhou, Zhejiang Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Affliated Hangzhou First People's Hospital, School of Medicine, Westlake University","place":["Hangzhou, Zhejiang Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanhan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Affliated Hangzhou First People's Hospital, School of Medicine, Westlake University","place":["Hangzhou, Zhejiang Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Affliated Hangzhou First People's Hospital, School of Medicine, Westlake University","place":["Hangzhou, Zhejiang Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1080\/14397595.2019.1709944","article-title":"2019 Diagnostic criteria for mixed connective tissue disease (MCTD): from the Japan research committee of the ministry of health, labor, and welfare for systemic autoimmune diseases","volume":"31","author":"Tanaka","year":"2021","journal-title":"Modern Rheumatology"},{"key":"B2","first-page":"136","article-title":"Undifferentiated connective tissue disease, mixed connective tissue disease, and overlap syndromes in rheumatology","volume":"113","author":"Pepmueller","year":"2016","journal-title":"Mo Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1177\/0961203314554248","article-title":"Recurrent spontaneous subdural hematoma secondary to immune thrombocytopenia in a patient with overlap syndrome","volume":"24","author":"Goh","year":"2015","journal-title":"Lupus"},{"key":"B4","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.berh.2012.01.009","article-title":"Mixed connective tissue disease: an overview of clinical manifestations, diagnosis and treatment","volume":"26","author":"Ortega-Hernandez","year":"2012","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"94","DOI":"10.5114\/reum.2015.51509","article-title":"U1-RNP and TLR receptors in the pathogenesis of mixed connective tissue disease. 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