Ultrasound-Guided Thrombin Injection for Iliopsoas Pseudoaneurysm

Bilateral iliopsoas hematoma is an uncommon phenomenon, which has been described in individuals receiving anticoagulation therapy. The hematoma is caused by bleeding of arteries to the muscle. In rare cases, pseudoaneurysms can also be formed. We present a case of an adolescent, with partial factor XI deficiency, who experienced a mild fall. Imaging studies revealed large bilateral iliopsoas hematomas and bilateral iliopsoas pseudoaneurysms. One pseudoaneurysm was demonstrated by angiography and was embolized with micro coils. The second, more persistent one, was sealed via ultrasound-guided thrombin injection, with excellent morphological and clinical results.