A Case of Iliopsoas Hematoma Caused by Prophylactic Anticoagulation against          COVID-19

Masaki, Shoichi; Takahashi, Tadashi; Sahara, Toshinori; Endo, Ryo; Obana, Masayoshi

doi:10.2490/prm.20220004

Cited by 3 publications

(3 citation statements)

References 14 publications

(13 reference statements)

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“…In the case of surgical approaches for treating IPH, techniques including open surgery, interventional embolization, CT or ultrasound-guided puncture aspiration, and the injection of coagulation enzymes have been reported [10,22] . However, hematoma recurrence is a possibility with this strategy.…”

Section: Discussionmentioning

confidence: 99%

Clinical Case Analysis of Iliopsoas Hematoma Causing with Femoral Nerve Compression

Li,

Peng,

Gong

et al. 2023

Preprint

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Background: To investigate the clinical manifestation and prognosis of iliopsoas hematoma (IPH) associated with femoral nerve compression and enhance the current understanding of IPH. Methods: Patients diagnosed with IPH from March 2014 to January 2023 at the Affiliated Hospital of Southwest Medical University were assessed. The main clinical indicator observed was visual analog scale (VAS) score before treatment as well as at 1 week and 1, 3, and 6 months after treatment. Secondary indicators included the degree of lower limb numbness before and after treatment, muscle strength, hip flexion degree, the distribution of affected nerves, hematoma size, and hematoma distribution. Results: A total of 28 patients were included, among which 24 were men, and the average age (median [interquartile range]) was 48 (20.25, 63) years. The average duration of disease onset was 3 (1.25, 7) days, and 16 patients (57.14%) exhibited coagulation dysfunction. After 1 week of treatment, a 50% reduction in the VAS score was noted in 18 patients (64.28%). Furthermore, VAS score at 1 week and 1, 3, and 6 months after treatment were significantly lower than the baseline VAS score (P < 0.05). Baseline lower limb sensation was grade I in two patients, followed by grades II, III, and IV in five, 11, and 10 patients, respectively. After 6 months, 22 patients (78.57%) recovered to grade I. Baseline muscle strength of the lower limb was grade II in one patient, while grades III, IV, and V were in 10, eight, and nine patients, respectively. After 6 months, 19 patients (67.85%) exhibited improvement to grade V. The baseline degree of hip flexion was graded I and II in 53.57% of the patients, with enhancement to grade III after 6 months in 25 (89.28%). Hematoma distribution was localized in the mid-zone in 21% of the patients; upper-mid zone, 29%; mid-lower zone, 29%; and upper-mid-lower zone, 21%. In terms of affected nerves, femoral nerve involvement was revealed in 25 patients (89.28%), whereas lateral femoral cutaneous nerve involvement in 15 (53.57%). Conclusions: IPH is mainly caused by coagulation dysfunction and is often accompanied by pain and femoral nerve involvement that result in slow neurological recovery. Furthermore, the timely detection and causal treatment of IPH may help achieve a favorable prognosis.

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Section: Discussionmentioning

confidence: 99%

Clinical Case Analysis of Iliopsoas Hematoma Causing with Femoral Nerve Compression

Li,

Peng,

Gong

et al. 2023

Preprint

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“…The authors of the study reported that the risk of VTE and bleeding was comparable in patients with COVID-19, but further randomized studies are needed to determine the optimal dose of thromboprophylaxis in patients with COVID-19. In a review of the literature, we found some case reports of IPH (iliopsoas hematoma) [ 4 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Bleeding into the Abdominal and Ilio-Lumbar Muscles—A Rare Complication in the Course of COVID-19: Analysis of Four Cases and a Literature Review

Mackiewicz−Milewska

Sakwińska

Cisowska-Adamiak

et al. 2022

JCM

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The risk of venous thromboembolic (VTE) complications, mainly in the form of pulmonary embolism (PE) and deep vein thrombosis (DVT), in COVID-19 is well known, necessitating the administration of thrombotic prophylaxis in most patients. With a high risk of VTE complications or their presence, full anticoagulation may be associated with hemorrhagic complications. COVID-19 bleeding is rarely reported. Here, we present four cases of patients with muscle bleeding: two in the iliopsoas muscle, which resulted in death despite the embolization of the bleeding vessel, and two in the oblique and straight abdominal muscles, which were treated conservatively. In the reported cases, the severity of the bleeding coincided with the severity of the course of COVID-19. When observing a sudden drop in hemoglobin (Hb) in a patient with COVID-19, one must always remember the possible complications in the form of muscle bleeding, which can be fatal.

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“…These patients require comprehensive, multidisciplinary rehabilitation to regain their capacity for activities of daily living. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ) The survival rate of patients with COVID-19 varies depending on the strain, with infection with the Omicron strain resulting in a higher survival rate than that with the Delta strain. Recently, the overall survival rate of patients with COVID-19 has increased because of the prevalence of the Omicron strain.…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation of Patients with Post-COVID-19 Syndrome: A Narrative Review

Sakai

Hoshino

Hirao

et al. 2023

PRM

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Objectives : We aimed to review the most recent articles on the rehabilitation of patients after coronavirus disease 2019 (COVID-19) and to identify the methods and effects of rehabilitation on such patients. Methods : A literature search was conducted using PubMed and Web of Science from study inception to October 2022 using the following search terms to identify meta-analyses and randomized controlled studies with abstracts written in English: [“COVID-19” or “COVID 19” or “2019-nCoV” or “SARS-CoV” or “novel coronavirus” or “SARS-CoV-2”] and [“rehabilitation”]. Publications investigating the effects of pulmonary and physical rehabilitation on patients with COVID-19 were extracted. Results: The extraction process selected four meta-analyses, two systematic reviews, two literature reviews, and two randomized controlled trials. Pulmonary rehabilitation recovered forced vital capacity (FVC), 6-min walk distance (6MWD), health-related quality of life (HRQOL), and dyspnea. Pulmonary rehabilitation increased predicted FVC, distance in the 6MWD test, and HRQOL score compared with baseline values. Physical rehabilitation, comprising aerobic exercises and resistance training, effectively improved fatigue, functional capacity, and quality of life with no adverse events. Telerehabilitation was an effective tool to provide rehabilitation for patients with COVID-19. Conclusions: Our study suggests that rehabilitation after COVID-19 should be considered an effective therapeutic strategy to improve the functional capacity and quality of life of patients with COVID-19.

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A Case of Iliopsoas Hematoma Caused by Prophylactic Anticoagulation against COVID-19

Cited by 3 publications

References 14 publications

Clinical Case Analysis of Iliopsoas Hematoma Causing with Femoral Nerve Compression

Clinical Case Analysis of Iliopsoas Hematoma Causing with Femoral Nerve Compression

Bleeding into the Abdominal and Ilio-Lumbar Muscles—A Rare Complication in the Course of COVID-19: Analysis of Four Cases and a Literature Review

Rehabilitation of Patients with Post-COVID-19 Syndrome: A Narrative Review

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