DOI: http://dx.doi.org/10.18203/2349-2902.isj20200544

A rare case of iliopsoas hematoma in a patient with von Willebrand disease

Vikas Kawarat, Mohamed Javid, Shanthi Ponnandai Swaminathan, Kannan Ross

Abstract


Iliopsoas hematoma is a serious complication that can occur in bleeding disorders, most commonly hemophillia but it can also be seen in von Willebrand disease (vWD) in less frequency. This can cause muscle pain, muscle dysfunction and sometimes even femoral nerve palsy. Iliopsoas hematomas can be diagnosed by the usage of ultrasonography, computed tomography (CT) or magnetic resonance imaging (MRI). Here we report a case of a 20-year-old boy who presented to us with complaints of pain in the right lower quadrant, flank, and inguinal region for a week. He was diagnosed with vWD type 3 when he was 10 years old. The symptoms started after he had tried to kick start his motorbike vigorously. Clinical examination revealed the patient to be in an anti-pain posture and to have tenderness at sites where he complained of pain. A subsequent CT scan showed that there was an iliopsoas hematoma of size 10×6 cm. The patient was managed conservatively with factor replacement and physiotherapy following which there was amelioration in the symptoms and the patient recovered well.


Keywords


Iliopsoas hematoma, von Willebrand disease, CT scan

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References


Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran pathologic basis of disease, professional edition e-book. Elsevier health sciences; 2014.

Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 20th ed. New York, NY: McGraw-Hill; 2018.

Wada Y, Yanagihara C, Nishimura Y. Bilateral iliopsoas hematomas complicating anticoagulant therapy. Intern Med. 2005;44:641-3.

Keikhaei B, Soltani Shirazi A. Spontaneous iliopsoas muscle hematoma in a patient with von Willebrand disease: a case report. J Med Case Reports. 2011;5(1).

Tallroth A. Hemophilia with spontaneous hemorrhage in the iliopsoas muscle followed by injury to the femoral nerve. Acta Chirurgica Scandinavica. 1939;82:1.

Chen YC, Yang L, Cheng SN, Hu SH, Chao TY. von Willebrand disease: a clinical and laboratory study of sixty-five patients. Ann Hematol. 2011;90:1183-90.

Federici AB, Castaman G. Italian Association of Hemophilia Centers (AICE). Guidelines for the diagnosis and management of von Willebrand disease in Italy. Haemophilia. 2002;8:607-21.

Pailhes R, Lafosse J, Marty P, Dahan O, Voisin S, Sié P. Large psoas haematoma and femoral neuropathy in a patient with type 2B von Willebrand's disease. Haemophilia. 2012;18(6):407-8.