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Spontaneous Iliopsoas Haematoma Presenting with Groin Pain under Warfarin Therapy.

A 68-year-old man was admitted with complaints of groin pain and restriction in the left hip movements for the last 3 days. The patient stated that he had been under warfarin treatment due to cardiac valve replacement. On admission, he was hemodynamically stable. Physical examination revealed paresthesia over the left thigh and restriction in left hip joint movements. The left groin was painful with palpation as well. Laboratory test results were consistent with decreased level of hemoglobin (10.5 g/dL) compared with 3 months ago (15.9 g/dL) and increased level of international normalized ratio (INR) (12.7, normal ranges: 0.9 – 1.3). Contrast-enhanced computed tomography of the abdomen was consistent with the hematoma of the left iliopsoas muscle (Fig. 1). Two units of fresh frozen plasma and intravenous vitamin K were administered for the correction of coagulation profile. The patient was discharged 8 days later with a stable level of INR (2.4). On discharge, left leg pain did improve, but anterior thigh paresthesia did not. Follow-up visits were recommended.