Femoral Neuropathy Due to Retroperitoneal Bleeding

Heparin sodium therapy occasionally causes retroperitoneal bleeding that may dissect around the femoral nerve resulting in femoral neuropathy. This complication is frequently not recognized, the mode of presentation being remote from the actual site of bleeding, and may even be confused with other problems, such as femoral embolism, which it may mimic. Thorough knowledge of the anatomy of the femoral nerve leads one to suspect the probable occurrence of this condition, and the diagnosis can frequently be inferred from the fact that the signs and symptoms relate directly to the distribution of the femoral nerve. Three cases of retroperitoneal bleeding occurred after myocardial infarction in patients being treated with heparin. The signs and symptoms, important differentials, clinical treatment, and course explain the observations in light of the pathologic anatomy.