Occult brodifacoum poisoning presenting as a massive intramuscular hematoma.
Guangcai Yu, Shizhen Lv, Jianjian Liu et al.
✦ AI-curated · Sources linked
Case in brief
A 56-year-old man presented with significant swelling in his right thigh, which had developed over nine days without any recent trauma. Laboratory tests indicated severe coagulopathy with an elevated PT and INR, alongside a confirmed large intramuscular hematoma. This followed a prior episode of gastrointestinal bleeding and coagulopathy linked to brodifacoum poisoning, which had been treated but recurred when the patient declined further vitamin K treatment.
Diagnostic / clinical pearl
Clinicians should consider brodifacoum poisoning in patients with unexplained coagulopathy and significant hematomas, even in the absence of external bleeding.
Why it matters
Recognizing that a large intramuscular hematoma can be the sole manifestation of brodifacoum poisoning is crucial for timely diagnosis and management.