Hip Pelvis.  2014 Mar;26(1):50-54. 10.5371/hp.2014.26.1.50.

Non-operative Treatment of Femoral Neuropathy Caused by Iliacus Hematoma: A Case Report

• Jin JM
• Kwon SY
• Lee HJ
• Lee JY

• KMID: 2054163
• DOI: http://doi.org/10.5371/hp.2014.26.1.50

Abstract

Treatment of femoral neuropathy caused by iliacus hematoma can be divided according to operative treatment and non-operative treatment. Recently, percutaneous drainage has been more popular because it is relatively simple, convenient, and less invasive. After warfarin overuse, a 71-year-old male patient visited the emergency room with femoral neuropathy caused by a left iliacus muscle hematoma measuring approximately 110x64 mm, 75x60 mm in size on coronal and sagittal computed tomography angiograhy. Without trauma, weakness of the left hip flexor and left knee extensor was noted with strength of 2/5 (poor) each. Immediate medical treatment using vitamin K and fresh frozen plasma was started and percutaneous drainage was performed. Two days after visiting the emergency room, neurological symptoms were improved and non-operative treatment was continued. Twenty four days after being hospitalized, the size of the hematoma was reduced to approximately 75x45 mm, 62x40 mm in size. Approximately three months after hospitalization, most of the hematoma was absorbed. After one year, mild atrphy of quadriceps and mild diffuse pain were noted, however, no other symptoms were observed.

Keyword

Iliacus hematoma; Femoral neuropathy; Non-operative treatment; Percutaneous drainage

MeSH Terms

Aged
Drainage
Emergency Service, Hospital
Femoral Neuropathy*
Hematoma*
Hip
Hospitalization
Humans
Knee
Male
Plasma
Vitamin K
Warfarin
Vitamin K
Warfarin

Figure

• 

  Fig. 1 The abdominal and pelvic computed tomographic angiography. Axial (A) and sagittal (B) images revealing a hematoma in the left iliacus muscle (white arrowheads).

• 

  Fig. 2 Computed tomographic images at 24 days after hospitalization. Axial (A) and sagittal (B) images show a decreased amount of hematoma in the left iliacus muscle (white arrowheads).

• 

  Fig. 3 Computed tomographic images at 3 months after hospitalization. Axial (A) and sagittal (B) images show complete dissolution of the hematoma (black arrows).

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