HEMATOMAS OF THE ILIAC PSOAS - 29 CASES

We present 29 cases of haematoma of the iliac psoas muscle, following anticoagulant treatment and review 158 cases so far published. In 60 p . 100 of cases, the anticoagulant was some form of intravenous or sube utaneous heparin ; prescribed in 40 p. 100 of cases for venous thrombo sis followed rapidly by pulmonary embolism, in half the cases between the 3rd and the 14th day. Hypocoagulation was excessive in 64 p. 100 o f the cases. Clinically the onset is marked in all cases by a violent pain in the territory of femoral nerve, anaemia (40 p. 100) psoitis (3 2 p. 100) and iliac mass (51 p. 100), ecchymosis (13 p. 100) and parti cularly 23 among 29 cases an early or late femoral paralysis. The clin ical diagnosis has been confirmed by echography 21 cases an or CT scan (7 cases). Our approach has been definitely surgical. The surgical pr ocedure carried out in 20 p. 100 of the cases published, and in 23 of our ones, relieves the pain, provides for an early efficient physiothe rapy, and a regression of the femoral paralysis, much more rapidly and completely than in the absence of surgery. The anatomical lesions, an d the condition of the femoral nerve are described in the operative re cords, account for that evolution and explain our position. Traumatic and hemophilic have evocated.