Bleeding complications should be considered in the differential diagnosis of any patient on warfarin therapy. A 66-year-old man presenting with right groin pain due to a spontaneous iliopsoas hematoma is reported. Computed tomography of the abdomen and pelvis at the emergency department confirmed the diagnosis. Fresh frozen plasma was given to correct the clotting derangement. The patient was managed conservatively. He was subsequently discharged well without complication. Iliopsoas haematoma or spontaneous retroperitoneal haemorrhage is an uncommon complication that needs to be considered in the differential diagnosis of a patient on warfarin therapy with abdominal, flank or groin pain.
BeythR.J.Management of haemorrhagic complications associated with oral anticoagulant treatment. Expert Opin Drug Saf2002; 1(2): 129–36.
2.
DautyM., SigaudM., TrossaertM., FressinaudE., LetenneurJ., DuboisC.Iliopsoas hematoma in patients with hemophilia: a single-center study. Joint Bone Spine2007; 74(2): 179–83.
3.
MarquardtG., Barduzal AnglesS., LehetaF., SeifertV.Spontaneous hematoma of the iliac psoas muscle: a case report and review of literature. Arch Orthop Trauma Surg2002; 122(2): 109–11.
4.
SugiyamaC., AkaiA., YamakitaN., IkedaT., YasudaK.Muscle hematoma: a critically important complication of alcoholic liver cirrhosis. World J Gastroenterol2009; 15(35): 4457–60.
5.
OnoderaM., FujinoY., InoueY., KikuchiS., EndoS.Hematoma of the iliopsoas muscle due to thrombocytopenia resulting from the administration of a third generation cephalosporin. Ann Hematol2010; 89(8): 825–6.
OngH.S.Compressive femoral neuropathy: a rare complication of anticoagulation. Singapore Med J2007; 48(3): e94–5.
11.
PhillipsS., BarrA., WilsonE., RockallT.A., StebbingJ.F.Two cases of retroperitoneal haematoma caused by interaction between antibiotics and warfarin. Emerg Med J2006; 23(1): e8.
12.
NakaoA., SakagamiK., MitsuokaS., UdaM., TanakaN.Retroperitoneal hematoma associated femoral neuropathy: a complication under antiplatelet therapy. Acta Med Okayama2001; 55(6): 363–6.
