© 2002 The Fellowship of Postgraduate Medicine
Iatrogenic groin pain
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The triad of groin pain, hip flexion, and femoral neuropathy indicates iliopsoas sheath haemorrhage. This condition occurs in patients with inherited coagulation disorders, particularly haemophilia A, and in patients on oral anticoagulants.1,2 Spontaneous haemorrhage occurs deep to the iliacus fascia from the iliacus or psoas muscles, blood tracking from the retroperitoneal space into the pelvic extraperitoneal space. Occasionally massive bleeding can lead to signs of volume deficit.
The iliacus fascia invests the psoas major and iliacus muscles and continues inferiorly as the posterior wall of the femoral sheath. This explains the association with femoral neuropathy, the nerve lying in the groove between the iliacus and psoas muscles. The predilection for the iliacus muscle is unclear.
The computed tomograms shows a collection behind the left iliacus muscle which displaces this anteriorly and separates it from the iliac blade. The left iliopsoas muscle appears enlarged with heterogeneous attenuation internally.
In our patient,
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- Iatrogenic groin pain
- K Sanyal and A Banerjee
Postgrad. Med. J. 2002 78: 627.[Extract] [Full Text] [PDF]
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