Early Surgical Treatment for Iliopsoas Hematoma in Patient with Mild Hemophilia
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Conservative treatment reveals good response to muscle hemorrhage with hemophilia. We report here a 16-year-old boy with mild hemophilia who had surgical removal of iliopsoas hematoma. He was referred to the hospital with a chief complaint of inguinal pain. At presentation, his left lower extremity developed psoas position and desensitization was shown on anterior and lateral aspect of the left thigh. Hemorrhage located in the left pelvic cavity onCT accounted for his neurological symptoms. He was diagnosed with iliopsoas hematoma and impairment of both left femoral nerve and left lateral femoral cutaneous nerve. At first he was treated with conservative therapy, bed rest, analgesic and coagulation factor replacement; however, deterioration of neurological symptoms prompted us to surgically remove the hematoma on the sixth day from onset. Inguinal pain was decreased remarkably after the operation. He could walk on crutches and was discharge on the eighth postoperative day. About 2 months later, the neurological symptom was normalized completely. It is necessary to recognize the anatomical specificity especially with the iliopsoas hematoma among muscle hemorrhage of the hemophilic patient because neurological damage tends to occur. It is reported that iliopsoas hematoma is occasionally seen in the mild hemophilia patient. In conclusion, it is important to take prompt surgical intervention to evade irreversible neurodegeneration in cases with poor response to conservative treatment.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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