Iliopsoas Muscle Hematoma Secondary to Alcoholic Liver Cirrhosis

Iliopsoas muscle hematoma in a patient with alcoholic liver cirrhosis is rarely seen, however it has a high mortality. Thus we should cautiously make a diagnosis and treatment. This is the case of a 60-year-old male. He had a 15-year history of alcoholic liver disease and emphysema. He presented with low back pain after a fall that had happened 2 months before. Due to persistent back pain, he went to see a local physician who, after detailed examination, suspected rupture of bilateral common iliac artery aneurysms and transferred the patient to our hospital. The same presumptive diagnosis was made, and on this basis, an aortic bifemoral Y-graft was implanted. He developed aspiration pneumonia and hepatic and renal dysfunction postoperatively, which led to multiple organ failure and subsequent in-hospital death on postoperative day 62. This was believed to be a case of iliopsoas muscle hematoma developed in a patient with liver cirrhosis, and considering it was a case with poor surgical risk, a conservative treatment option such as transcatheter arterial embolization should also have been considered. Although iliopsoas muscle hematoma with alcoholic liver cirrhosis is rare, an appropriate treatment plan should be determined on a case-by-case basis despite its poor prognosis.

[1]  N. Yamakita,et al.  Muscle hematoma: a critically important complication of alcoholic liver cirrhosis. , 2009, World Journal of Gastroenterology.

[2]  Teruo Sakamoto,et al.  A case of idiopathic iliopsoas hemorrhage in an alcohol abuser effectively treated with vitamin K therapy , 2009 .

[3]  Y. Shih,et al.  Spontaneous intracranial hemorrhage in cirrhotic patients , 2008, Clinical Neurology and Neurosurgery.

[4]  G. Bartal,et al.  Transcatheter arterial embolisation in anticoagulant‐related haematoma – a current therapeutic option: a report of four patients and review of the literature , 2007, International journal of clinical practice.

[5]  M. Trossaërt,et al.  Iliopsoas hematoma in patients with hemophilia: a single-center study. , 2007, Joint, bone, spine : revue du rhumatisme.

[6]  A. D. Di Bisceglie,et al.  Spontaneous retroperitoneal and rectus muscle hemorrhage as a potentially lethal complication of cirrhosis , 2006, Liver international : official journal of the International Association for the Study of the Liver.

[7]  P. Mueller,et al.  Rectus Sheath Hematoma: Review of 126 Cases at a Single Institution , 2006, Medicine.

[8]  K. Kavaklı,et al.  Iliopsoas haemorrhage in patients with haemophilia: results from one centre , 2005, Haemophilia : the official journal of the World Federation of Hemophilia.

[9]  A. Lorsheyd,et al.  Rapid intake of alcohol (binge drinking) inhibits platelet adhesion to fibrinogen under flow. , 2004, Alcoholism, clinical and experimental research.

[10]  Yoshinobu Sato,et al.  Liver transplantation in an endostage cirrhosis patient with abdominal compartment syndrome following a spontaneous rectus sheath hematoma , 2004, Journal of gastroenterology and hepatology.

[11]  Y. Hiasa,et al.  A case of alcoholic liver cirrhosis complicated with iliopsoas hematoma:difficulty in discriminating the diagnosis of progressive anemia , 2004 .

[12]  H. Kawakami,et al.  [Two cases of alcoholic liver cirrhosis associated with intramuscular hematoma]. , 2002, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology.

[13]  A. Karter,et al.  Is insulin sensitivity a causal intermediate in the relationship between alcohol consumption and carotid atherosclerosis?: the insulin resistance and atherosclerosis study. , 2002, Diabetes care.

[14]  N. Kawai,et al.  [A case of iliopsoas hematoma associated with liver cirrhosis, management by transcatheter arterial embolization]. , 2000, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology.

[15]  A. Craxì,et al.  Clinical aspects of bleeding complications in cirrhotic patients , 2000, Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.

[16]  N. Yamakita,et al.  [A case of idiopathic iliopsoas hematoma associated with liver cirrhosis]. , 1998, Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology.

[17]  T. Brandon,et al.  Effects of Ethanol and Hemolysis on In Vivo and In Vitro Platelet Aggregation , 1982, Journal of cardiovascular pharmacology.