title: Bilateral iliopsoas intramuscular bleeding following anticoagulant therapy with heparin: a case report.
abstract: Iliopsoas haematoma is an uncommon complication that may arise during anticoagulant therapy, especially with heparin and warfarin. Besides determining patient distress secondary to femoral nerve compression, this event may progress to life-threatening complications and require expensive treatments. We describe the case of a 70-year-old healthy man complaining of severe bilateral groin, lumbar and thigh pain, and paralytic ileus after therapy with heparin. The angio-computed tomography scan observed bilateral iliopsoas haematomas. In view of the clinical and radiological scenarios, we ordered a diagnostic and therapeutic angiography of the bleeding vessels by trans-catheter arterial embolization of the fourth right lumbar artery trunk. The treatment proved to be beneficial from a clinical, radiological and laboratory point of view. To the best of our knowledge, this is the first reported case of bilateral iliopsoas haematoma occurring in a male treated with therapeutic levels of heparin alone.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Insubria University Viale Borri 57, 21100 Varese Italy. luigi.murena@uninsubria.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Murena
authors.forename: Ettore
authors.initials: E
authors.lastname: Vulcano
authors.forename: Emanuela
authors.initials: E
authors.lastname: Salvato
authors.forename: Marco
authors.initials: M
authors.lastname: Marano
authors.forename: Fabio
authors.initials: F
authors.lastname: D'Angelo
authors.forename: Paolo
authors.initials: P
authors.lastname: Cherubino