Femoral neuropathy following retroperitoneal hemorrhage: case series and review of the literature.
Femoral neuropathy due to retroperitoneal hematoma has been infrequently described in the literature. While occasionally due to trauma, it has been most commonly reported in association with various bleeding diatheses and therapeutic anticoagulation. As the indications for the use of anticoagulants and antiplatelet agents increase, associated hemorrhagic complications will likely also increase. The management of retroperitoneal hematoma with consequent femoral nerve palsy remains controversial. We present a series of four cases of femoral nerve palsy due to retroperitoneal hematoma managed by surgical decompression. Hematoma evacuation at the time of the development of femoral neuropathy results in immediate benefit, with greater likelihood of a return to pre-event neurological status. Delays in operative treatment, despite the presence of a neurological deficit, may lead to significant and prolonged neurological dysfunction. Surgical decompression should be highly considered in all patients who develop femoral neuropathy from a retroperitoneal hematoma.
Parmer
Shane S
SS
Division of Vascular Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Carpenter
Jeffrey P
JP
Fairman
Ronald M
RM
Velazquez
Omaida C
OC
Mitchell
Marc E
ME
D000293:Adolescent; D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D019299:Decompression, Surgical; D005260:Female; D020428:Femoral Neuropathy / Q000209:etiology* / Q000601:surgery; D006406:Hematoma / Q000139:chemically induced / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006470:Hemorrhage / Q000139:chemically induced / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology* / Q000601:surgery; D012187:Retroperitoneal Space; D012307:Risk Factors
D000925:Anticoagulants