Emergency department ultrasound diagnosis of spontaneous iliopsoas haemorrhage in a patient on warfarin.
A 87-year-old man presented to the emergency department (ED) with right-sided abdominal and thigh pain which had been present for the last 3 days and was getting worse. He had been diagnosed with a deep venous thrombosis of the left common femoral and superficial veins 10 days previously and had been discharged on a loading dose of warfarin and low-molecular weight heparin (dalteparin) injections. Despite his international normalised ratio being only 2.4, an ED ultrasound showed an unusual mass in the right iliac fossa, partly cystic and partly solid. A CT scan was performed which showed the lesion was a haematoma in the right iliopsoas muscle mass.
Department of A&E Medicine, Frimley Park Hospital, Camberley, UK.
Devesh
D
Sharma
Ramy
R
Saker
Abha
A
Govind
D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D006470:Hemorrhage / Q000139:chemically induced / Q000175:diagnosis*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D016658:Psoas Muscles / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000150:complications* / Q000188:drug therapy; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin