Iliopsoas haematoma: a rare complication of warfarin therapy

J Coll Physicians Surg Pak. 2012 Oct;22(10):673-4. doi: 10.2012/JCPSP.673674.

Abstract

Iliopsoas haematoma is a rare complication that occurs in patients receiving anticoagulant therapy. The clinical manifestation of iliopsoas haematoma is non-specific. It can mimic orthopaedic or neurological disorders, including paraesthesia or paresis of the thigh and leg due to compression of the nerve plexus. Among the many available diagnostic modalities, computed tomography is the most useful radiological method for diagnosis. Treatment approaches for iliopsoas haematoma include conservative therapy, surgical intervention, or transcatheter arterial embolisation. Conservative therapy consists of bed rest, restoration of circulating volume, and drug discontinuation for correcting underlying coagulopathy. Although a conservative approach is the first choice, transcatheter arterial embolisation and surgical intervention may be required in patients with hemodynamically unstable and active bleeding. The report described a case of iliopsoas haematoma due to anticoagulant therapy with paraesthesia in the left leg who was successfully treated by conservative approach.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Aged
  • Anticoagulants / adverse effects*
  • Female
  • Femoral Nerve
  • Hematoma / chemically induced*
  • Hematoma / complications*
  • Hematoma / diagnostic imaging
  • Hematoma / therapy
  • Humans
  • Paresis / etiology
  • Psoas Muscles / blood supply
  • Rare Diseases / chemically induced
  • Rare Diseases / complications*
  • Rare Diseases / diagnostic imaging
  • Rare Diseases / therapy
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vitamin K / administration & dosage
  • Warfarin / adverse effects*

Substances

  • Anticoagulants
  • Vitamin K
  • Warfarin