Abstract
Iliopsoas haematoma is an uncommon complication that may arise during anticoagulant therapy, especially with heparin and warfarin. Besides determining patient distress secondary to femoral nerve compression, this event may progress to life-threatening complications and require expensive treatments. We describe the case of a 70-year-old healthy man complaining of severe bilateral groin, lumbar and thigh pain, and paralytic ileus after therapy with heparin. The angio-computed tomography scan observed bilateral iliopsoas haematomas. In view of the clinical and radiological scenarios, we ordered a diagnostic and therapeutic angiography of the bleeding vessels by trans-catheter arterial embolization of the fourth right lumbar artery trunk. The treatment proved to be beneficial from a clinical, radiological and laboratory point of view. To the best of our knowledge, this is the first reported case of bilateral iliopsoas haematoma occurring in a male treated with therapeutic levels of heparin alone.
Highlights
Iliopsoas haematoma is an uncommon complication that may arise during anticoagulant therapy, especially with heparin and warfarin
We describe the case of a 70-year-old healthy man complaining of severe bilateral groin, lumbar and thigh pain, and paralytic ileus after therapy with heparin
To the best of our knowledge, this is the first reported case of bilateral iliopsoas haematoma occurring in a male treated with therapeutic levels of heparin alone
Summary
Iliopsoas haematoma is an uncommon complication that may arise during anticoagulant therapy, especially with heparin and warfarin. Cases Journal 2009, 2:7534 http://casesjournal.com/casesjournal/article/view/7534 surgery department for a circular blade injury He presented a deep lesion of the anterior aspect of the right elbow, with complete section of the humeral artery, median and radial nerves, and radial capitellum fracture. Suspecting a myeloradiculitis we ordered a lumbar MRI, which was negative for nerve root compression His condition deteriorated over the following two days in terms of groin and lumbar pain, with haemoglobin values and platelet count down to 8.6 g/dL and 86,000 per μl respectively. The following three days, the patient was transfused with a total of six packed red blood cells units (two per day) given a nonincreasing haemoglobin value (range, 8.2 to 8.7 g/dL), and four units of fresh frozen plasma given the platelet count progressively decreasing to 39,000 per μl. Radiological and laboratory parameters all returned within normal limits over the following 20 days
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