Hematoma de músculo iliopsoas na vigência de tratamento com varfarina

Abstract

Warfarin is a widely used drug for the prevention of thromboembolic events. Knowledge of its adverse effects is necessary for patient follow-up. Although the development of blood dyscrasias is a potential complication in these patients, retroperitoneal bleeding is rare. This article reports the case of a patient who developed iliopsoas muscle hematoma during treatment with warfarin after implantation of a metallic prosthetic aortic valve. The clinical manifestations involved important differential diagnoses.

Spontaneous Iliopsoas Hematoma in a Patient on Acenocoumarol: Report of a Rare Case

“…Several cases of this disorder have been reported in association with the prescription of anticoagulants during specific situations such as endovascular and cardiac procedures [ 5 ], treatment of some patients with COVID-19 [ 6 ], or in intensive care and intensive care unit patients [ 7 ]. Warfarin and heparin are the most pharmacological agents commonly implicated in these settings [ 8 ]. Haemophilia, alcoholic liver cirrhosis, chronic myeloid leukemia, and hypertensive emergencies have also been published as contributing conditions [ 9 ].…”

Subsequently occurring bilateral iliopsoas hematoma: a case report

“…Iliopsoas hematoma has been reported to occur mainly in relation to trauma; however, spontaneous iliopsoas hematoma has been reported in patients with coagulation problems, such as hemophilia, liver cirrhosis, and anticoagulants-related incidents [ 3 – 6 ].…”

“…Iliopsoas hematomas have also been associated with compressive femoral neuropathy, because the nerve can be compressed anywhere along its course. Femoral neuropathy and motor weakness of the lower extremity, develops in almost all patients [ 3 , 4 , 6 ].…”

“…There is no clear strategy for treatment of iliopsoas hematoma yet, and a variable treatment plan may be used according to the patient’s condition. Close monitoring is required when administering anticoagulants to prevent the possibility of complications occurring as a result of anticoagulant overuse [ 6 ]. However, despite conservative management, if fatal complications occur—such as femoral neuropathy, hypovolemic symptom or abdominal compartment syndrome—aggressive surgical intervention should be considered [ 4 , 7 ].…”