What is a iliopsoas hematoma?
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.
What causes iliopsoas hematoma?
Iliopsoas hematomas are typically caused by trauma in patients on anticoagulation/antiplatelet therapy or in those with hemophilia. [1,2,4] This entity was first reported by Tallroth in 1939 when he described an iliopsoas hemorrhage in a patient with hemophilia.
Where is iliopsoas hematoma?
Iliopsoas hematomas generally present with groin or thigh pain, muscle dysfunction, numbness or paresthesia of the unilateral lower extremity, and occasionally nerve palsy with the femoral nerve most commonly affected. Motor weakness may occur in chronic and large hematomas.
What is a iliopsoas?
Iliopsoas is a large compound muscle of the inner hip composed of the iliacus and psoas major muscle. Aside from the iliopsoas, other muscles of the inner hip include the psoas minor, obturator externus, obturator internus, superior gemellus, inferior gemellus, piriformis and quadratus femoris.
How is iliopsoas hematoma treated?
Iliopsoas hematoma has been treated successfully with conservative methods or surgical evacuation. Surgical methods that have been previously reported include transcatheter arterial embolization, percutaneous drainage of the hematoma and surgical decompression of the femoral nerve.
Can a hematoma cause nerve damage?
Small amounts of bleeding or bruising are common, and do not cause damage to nerves. A large haematoma may press on a nerve and cause damage. Rarely, an urgent operation is required to remove the haematoma and stop it pressing on the nerve.
Do hematomas move around?
The slow process of reabsorption of hematomas can allow the broken down blood cells and hemoglobin pigment to move in the connective tissue. For example, a patient who injures the base of their thumb might cause a hematoma, which will slowly move all through their finger within a week.
What is bilateral iliopsoas hematoma?
Iliopsoas hematoma is a rare complication associated with bleeding diathesis, trauma, and anticoagulant treatment [4]. Although hemorrhage is usually unilateral, a few cases report bilateral hematoma [1,2,5].
What is the prognosis of iliopsoas hematoma?
Iliopsoas hematoma was diagnosed on the basis of CT and managed promptly, before the development of femoral nerve palsy. Our patient responded very well to conservative treatment, and his hemoglobin level and coagulation profile improved to normal values within 12 hours.
What are the treatment options for iliopsoas hematoma?
The treatment of iliopsoas hematoma starts with conservative management, including bed rest, volume replacement, and drug discontinuation. Conservative management is usually sufficient in cases with small hematomas and mild femoral neuropathy associated with non-active bleeding [2,5].
What is spontaneous iliopsoas injury?
Spontaneous iliopsoas injury, most commonly associated with athletes, is a rare cause of atraumatic hip pain – yet it should remain on your differential when evaluating hip or low back pain among the elderly, especially when the patient is unable to ambulate. Spontaneous iliopsoas muscle or tendon injury is a rare cause of atraumatic hip pain.