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J Pediatr Intensive Care 2019; 08(03): 187-190
DOI: 10.1055/s-0039-1683385
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Ultrasound-Guided Thrombin Injection for Iliopsoas Pseudoaneurysm

Jonathan Weissmann
1   Vascular Surgery Unit, Meir Medical Center, Kfar Saba, Israel
,
Yigal Griton
2   Interventional Radiology Unit, Meir Medical Center, Kfar Saba, Israel
,
Shadi Mahajna
1   Vascular Surgery Unit, Meir Medical Center, Kfar Saba, Israel
,
Moanis Ajaj
1   Vascular Surgery Unit, Meir Medical Center, Kfar Saba, Israel
,
Simone Fajer
1   Vascular Surgery Unit, Meir Medical Center, Kfar Saba, Israel
› Author Affiliations
Further Information

Publication History

19 November 2018

01 February 2019

Publication Date:
05 March 2019 (online)

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Abstract

Bilateral iliopsoas hematoma is an uncommon phenomenon, which has been described in individuals receiving anticoagulation therapy. The hematoma is caused by bleeding of arteries to the muscle. In rare cases, pseudoaneurysms can also be formed. We present a case of an adolescent, with partial factor XI deficiency, who experienced a mild fall. Imaging studies revealed large bilateral iliopsoas hematomas and bilateral iliopsoas pseudoaneurysms. One pseudoaneurysm was demonstrated by angiography and was embolized with micro coils. The second, more persistent one, was sealed via ultrasound-guided thrombin injection, with excellent morphological and clinical results.

Keywords

pseudoaneurysm - iliopsoas hematoma - thrombin - factor XI deficiency - adolescent
 

  • References

  • 1 Dauty M, Sigaud M, Trossaërt M, Fressinaud E, Letenneur J, Dubois C. Iliopsoas hematoma in patients with hemophilia: a single-center study. Joint Bone Spine 2007; 74 (02) 179-183
    CrossrefPubMedSearch in Google Scholar
  • 2 Niakan E, Carbone JE, Adams M, Schroeder FM. Anticoagulants, iliopsoas hematoma and femoral nerve compression. Am Fam Physician 1991; 44 (06) 2100-2102
    PubMedSearch in Google Scholar
  • 3 Murena L, Vulcano E, Salvato E, Marano M, D'Angelo F, Cherubino P. Bilateral iliopsoas intramuscular bleeding following anticoagulant therapy with heparin: a case report. Cases J 2009; 2: 7534
    CrossrefPubMedSearch in Google Scholar
  • 4 Stören EJ. Bilateral iliacus haematoma with femoral nerve palsy complicating anticoagulant therapy. Acta Chir Scand 1978; 144 (03) 181-183
    PubMedSearch in Google Scholar
  • 5 Jamjoom ZA, al-Bakry A, al-Momen A, Malabary T, Tahan AR, Yacub B. Bilateral femoral nerve compression by iliacus hematomas complicating anticoagulant therapy. Surg Today 1993; 23 (06) 535-540
    CrossrefPubMedSearch in Google Scholar
  • 6 García-Alcázar D, García-Chapinal B, Batllori-Badia E. , et al. Psoas haematoma as a complication of Veress needle insertion: description of a case and literature review. BMC Surg 2014; 14 (01) 104
    CrossrefPubMedSearch in Google Scholar
  • 7 Sasson Z, Mangat I, Peckham KA. Spontaneous iliopsoas hematoma in patients with unstable coronary syndromes receiving intravenous heparin in therapeutic doses. Can J Cardiol 1996; 12 (05) 490-494
    PubMedSearch in Google Scholar
  • 8 Zissin R, Gayer G, Kots E, Ellis M, Bartal G, Griton I. Transcatheter arterial embolisation in anticoagulant-related haematoma--a current therapeutic option: a report of four patients and review of the literature. Int J Clin Pract 2007; 61 (08) 1321-1327
    CrossrefPubMedSearch in Google Scholar
  • 9 Wada Y, Yanagihara C, Nishimura Y. Bilateral iliopsoas hematomas complicating anticoagulant therapy. Intern Med 2005; 44 (06) 641-643
    CrossrefPubMedSearch in Google Scholar
  • 10 Holscher RS, Leyten FS, Oudenhoven LF, Puylaert JB. Percutaneous decompression of an iliopsoas hematoma. Abdom Imaging 1997; 22 (01) 114-116
    CrossrefPubMedSearch in Google Scholar
  • 11 Weiss JM, Tolo V. Femoral nerve palsy following iliacus hematoma. Orthopedics 2008; 31 (02) 178
    PubMedSearch in Google Scholar
  • 12 Lee K, Shin T, Choi J, Kim Y. Percutaneous injection therapy for a peripheral pulmonary artery pseudoaneurysm after failed transcatheter coil embolization. Cardiovasc Intervent Radiol 2008; 31 (05) 1038-1041
    CrossrefPubMedSearch in Google Scholar
  • 13 Casey P, Kausar A, Gavan D, Wilde N. Ultrasound-guided percutaneous thrombin for the management of superior mesenteric artery pseudoaneurysm. J Vasc Surg Cases 2015; 1 (03) 211-213
    PubMedSearch in Google Scholar
  • 14 Keeling AN, McGrath FP, Lee MJ. Interventional radiology in the diagnosis, management, and follow-up of pseudoaneurysms. Cardiovasc Intervent Radiol 2009; 32 (01) 2-18
    CrossrefPubMedSearch in Google Scholar
  • 15 Kovo M, Behar DJ, Friedman V, Malinger G. Pelvic arterial pseudoaneurysm-a rare complication of Cesarean section: diagnosis and novel treatment. Ultrasound Obstet Gynecol 2007; 30 (05) 783-785
    CrossrefPubMedSearch in Google Scholar
  • 16 La Perna L, Olin JW, Goines D, Childs MB, Ouriel K. Ultrasound-guided thrombin injection for the treatment of postcatheterization pseudoaneurysms. Circulation 2000; 102 (19) 2391-2395
    CrossrefPubMedSearch in Google Scholar
  • 17 Friedman SG, Pellerito JS, Scher L, Faust G, Burke B, Safa T. Ultrasound-guided thrombin injection is the treatment of choice for femoral pseudoaneurysms. Arch Surg 2002; 137 (04) 462-464
    PubMedSearch in Google Scholar
  • 18 Reus M, Morales D, Vázquez V, Llorente S, Alonso J. Ultrasound-guided percutaneous thrombin injection for treatment of extrarenal pseudoaneurysm after renal transplantation. Transplantation 2002; 74 (06) 882-884
    CrossrefPubMedSearch in Google Scholar
  • 19 Kang SS, Labropoulos N, Mansour MA, Baker WH. Percutaneous ultrasound guided thrombin injection: a new method for treating postcatheterization femoral pseudoaneurysms. J Vasc Surg 1998; 27 (06) 1032-1038
    CrossrefPubMedSearch in Google Scholar