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

Authors

  • Vikas Kawarat Department of General Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
  • Mohamed Javid Department of General Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
  • Shanthi Ponnandai Swaminathan Department of General Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India
  • Kannan Ross Department of General Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20200544

Keywords:

Iliopsoas hematoma, von Willebrand disease, CT scan

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.

References

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Published

2020-02-26

Issue

Section

Case Reports