Hematoma Causing Iliac Vein Compression Mimicking Deep Vein Thrombosis in an Elderly Patient with Hip Arthroplasty

Unilateral leg edema in elderly patients is often attributed to deep vein thrombosis (DVT), particularly when D-dimer levels are elevated. We report an unusual case of an elderly woman with subacute unilateral leg edema caused by compression of the external iliac vein by a traumatic hematoma following a minor fall. Contrast-enhanced computed tomography excluded DVT and revealed venous obstruction due to the hematoma. Percutaneous aspiration led to prompt resolution of the edema without the need for anticoagulation. This case underscores the importance of appropriate imaging to identify alternative etiologies of unilateral leg edema and avoid potentially harmful empiric anticoagulant therapy. J. Med. Invest. 73 : 291-293, February, 2026.