Emergency department ultrasound diagnosis of spontaneous iliopsoas haemorrhage in a patient on warfarin

Sharma, Devesh; Saker, R; Govind, Abha

doi:10.1136/bcr-2013-201291

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…The deep location of the muscle and the presence of overlying bowel loops make ultrasonographic assessment difficult [15]. CT images are superior to ultrasonography in displaying the density, site and extent of a retroperitoneal haematoma.…”

Section: Discussionmentioning

confidence: 98%

Spontaneous iliopsoas muscle haematoma during anticoagulant treatment

Retselas¹,

Vaiopoulos²,

Chronopoulos³

et al. 2015

Hellenic J Surg

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Spontaneous iliopsoas muscle haematoma is a rare complication in patients receiving anticoagulants. We present the case of spontaneous iliopsoas muscle haematoma in a 68-year-old male patient under anticoagulant therapy with dicumarol in combination with acetylsalicylic acid 100 mg. The patient was admitted with clinical symptoms of sudden pain and extensive swelling along his left abdominal lower quadrant, and clinical findings of a hard, pulseless, painful swelling of the left lateral abdomen with pain extending along the left femoroinguinal region. His pulse rate was 92/min and blood pressure 120/85 mm Hg. Laboratory investigations indicated a grossly deranged INR (17.7) and a drop in Hct (22.0%). The diagnosis of a left iliopsoas muscle haematoma was established with ultrasonography and computed tomography. The patient was managed conservatively with administration of fluids and a blood transfusion while the coagulation profile was corrected with vitamin K and fresh frozen plasma. The spontaneous iliopsoas muscle haematoma in patients who are on anticoagulant treatment is uncommon and its management controversial since approaches to therapy vary among conservative, interventional radiology and open surgery, depending on the cause and volume of the haematoma, timing of diagnosis, degree of neurological impairment and haemodynamical stability.

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Section: Discussionmentioning

confidence: 98%

Spontaneous iliopsoas muscle haematoma during anticoagulant treatment

Retselas¹,

Vaiopoulos²,

Chronopoulos³

et al. 2015

Hellenic J Surg

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show abstract

“…Spontaneous iliopsoas hematoma (SIPH) usually occurs in the context of anticoagulation, coagulopathies, and hemodialysis [ 4 ]. 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 ].…”

Section: Discussionmentioning

confidence: 99%

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

Bote¹,

Boughaleb²,

Lakssir³

et al. 2023

Cureus

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Spontaneous hematoma of the iliopsoas is a rare pathological circumstance; in the majority of cases published in the literature, it is associated with disorders of hemostasis due to anticoagulant treatment or coagulopathies. We present a case of a 64-year-old man on acenocoumarol, an anticoagulant of the vitamin K antagonist family, for atrial fibrillation, who presented with a severe left hip and flank pain with a huge ecchymosis on the left flank and a partial inability to extend the left thigh. A CT scan confirmed the diagnosis of iliopsoas hematoma. Given the hemodynamic stability of the patient, he benefited from a conservative treatment with a favourable evolution. This case highlights the underlying conditions, diagnosis, and treatment of this uncommon complication.

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“…Infective causes include psoas abscesses and hydatid cysts [ 7 ]. Psoas haemorrhage or haematoma will also present as a cystic lesion [ 8 ]. Rarer documented causes include a case of an endometrioma embedded in the psoas muscle body, pseudo-abscesses containing calcium pyrophosphate crystals in a patient with pseudogout and a meningocele extended through the L1 neural foramina [ 9–11 ].…”

Section: Discussionmentioning

confidence: 99%

A case of pancreatic pseudocyst as a rare cause of a cystic lesion within the psoas muscle

Doole

2021

Journal of Surgical Case Reports

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Acute pancreatitis is highly prevalent in Australia (Nesvaderani et al. Acute pancreatitis: update on management. Med J Aust 2015; 202 :420–3). Pancreatic pseudocysts, although typically occurring in the peripancreatic tissues, can in up to 25% be extra-pancreatic (Rasch et al. Management of pancreatic pseudocysts—a retrospective analysis. PLoS One 2017; 12 :e0184374). Extension of pseudocysts into the psoas muscle is highly unusual, with only 13 previously recorded cases (Gupta et al. Retroperitoneal cystic malignant fibromas mimicking a psoas abscess. Iran J Radiol 2015; 12 :e17507). This article presents the case of a 45-year-old man presenting with progressive left hip pain. He was known to have a history of chronic alcohol misuse. He presented with symptoms and signs typical of psoas pathology and was found to have a large pancreatic pseudocyst extending into his left psoas muscle. In this case, management was via both computed tomography guided percutaneous drainage and endoscopic ultrasound guided drainage. Because of the rarity of psoas pseudocysts and their propensity to mimic other pathology, diagnosis can be extremely challenging. Cystic lesions within the psoas muscle have several differentials, ranging from the more common psoas abscess to extremely rare neoplastic lesions.

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Emergency department ultrasound diagnosis of spontaneous iliopsoas haemorrhage in a patient on warfarin

Cited by 5 publications

References 8 publications

Spontaneous iliopsoas muscle haematoma during anticoagulant treatment

Spontaneous iliopsoas muscle haematoma during anticoagulant treatment

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

A case of pancreatic pseudocyst as a rare cause of a cystic lesion within the psoas muscle

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