Ilio-psoas Bleed mimicking Acute Appendicitis in a Newly Diagnosed Haemophilic; A Case Report of Near Miss Surgical Catastrophe

Abstract

Ilio-psoas hemorrhage is a serious complication in patients with Haemophilia. Bleeding into the ilio-psoas muscle can mimic acute  appendicitis clinically. Ilio-psoas hematoma is commoner in patients with Haemophilia than the general public and unlike the general  public where bleeding is secondary; it is usually spontaneous in haemophiliacs. We present a case of a 55-year- old man referred to the  emergency room with a history of abdominal pain and distention. We took a detailed history which led to a suspicion of Ilio-psoas  hematoma likely due to a bleeding disorder. Clotting profile and mixing studies supported the diagnosis of Haemophilia A. The diagnosis  of Ilio-psoas hematoma in Haemophilia is still a challenge and requires a high index of suspicion. It also requires careful history taking, a  detailed clinical examination and performing basic investigations to distinguish iliopsoas bleeding from other causes of acute abdomen    like acute appendicitis.