Rectus Sheath Hematoma: A Series of Unfortunate Events
Rectus sheath hematoma is rare. It can present to physicians in many specialties, but invariably the surgeon is contacted regarding management. It is frequently difficult to diagnose, which can result in delay of treatment or unnecessary surgery. Its incidence is on the rise.
We present a series of four cases of rectus sheath hematoma that presented to our hospital within a 5-month period. A comprehensive up-to-date review of the literature was undertaken.
Our research highlights the diagnostic dilemmas, the spectrum of severity (all three grades are represented), the complications, and the need for interdisciplinary awareness.
Rectus sheath hematoma is a rare but important entity in the differential diagnosis of abdominal pain. Interdisciplinary awareness of this condition is essential, as it is frequently difficult to diagnose, leading to delay in treatment or unneeded surgery. Grade 3 hematomas can lead to abdominal compartment syndrome and can be fatal.
KeywordsInternational Normalize Ratio Abdominal Compartment Syndrome Rectus Sheath Iliac Fossa Posterior Rectus Sheath
- 4.Werdehoff SG, Blomkalns AL. Rectus sheath hematoma. On eMedicine January 2005Google Scholar
- 7.Cavagna E, Carubia G, Schiavon F. Anatomo-radiologic correlations in spontaneous hematoma of the rectus abdominis muscles. Radiol Med (Torino) 2000;99:432–437Google Scholar
- 13.Linhares MM, Lopes Filho GJ, Bruna PC, et al. Spontaneous hematoma of the rectus abdominis sheath: a review of 177 cases with report of 7 personal cases. Int Surg 1999;64:251–257Google Scholar
- 14.Ergün N, Cevik AA, Holliman CJ, et al. Conservative management of giant abdominal wall hematoma. Ulus Trauma Derg 2004;10:141–144Google Scholar
- 16.Thia EWH, Low JJH, Wee HY. Rectus sheath hematoma mimicking an ovarian mass. Internet J Gynaecol Obstet 2003;2(1)Google Scholar
- 20.Berna JD, Garcia-Medina V, Guirao J, et al. Rectus sheath hematoma: diagnostic classification by CT. Abdom Imaging 1996;1:62–4Google Scholar
- 21.Park SH, Oh DR, Kim HK, et al. Spontaneous rectus sheath hematoma with hypovolaemic shock. J Korean Soc Emerg Med 2000;11:586–591Google Scholar
- 25.Mohapatra B. Abdominal compartment syndrome. Indian J Crit Care Med 2004;8:26–32Google Scholar