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Detection of Iliopsoas Hematoma by Retrospective Radiography in Veno-Venous Extracorporeal Membrane Oxygenation for a COVID-19 Patient.
Ohta, Soichi; Takahashi, Kohei; Iwashita, Masayuki; Abe, Takeru; Takeuchi, Ichiro.
  • Ohta S; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN.
  • Takahashi K; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN.
  • Iwashita M; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN.
  • Abe T; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN.
  • Takeuchi I; Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, JPN.
Cureus ; 14(2): e22571, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1761152
ABSTRACT
In coronavirus disease 2019 (COVID-19), veno-venous extracorporeal membrane oxygenation (VV-ECMO) is used to manage respiratory distress. This study's key clinical question was whether COVID-19 could be complicated by hemorrhagic and thrombotic events, such as iliopsoas hematoma (IPH), during the management of ECMO and the method to quickly and effectively detect IPH. A 52-year-old man with fever and dyspnea was diagnosed with COVID-19 pneumonia. He warranted VV-ECMO management on day 9, which was successfully tapered off on day 18. On day 20, computed tomography revealed a unilateral iliopsoas hematoma that was successfully managed with conservative care. However, a retrospective review of abdominal radiography performed on day 14 revealed a positive left psoas sign. When managing severe COVID-19 patients with VV-ECMO, cautious anticoagulative care and abdominal X-ray findings are warranted when considering the diagnosis of iliopsoas hematoma, including circulatory instability, anemia, and pain associated with limb movement.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Language: English Journal: Cureus Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Language: English Journal: Cureus Year: 2022 Document Type: Article