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. 2008 Jan 25:2:22.
doi: 10.1186/1752-1947-2-22.

Rectus sheath hematoma: three case reports

Selin Kapan  1 , Ahmet N Turhan, Halil Alis, Mustafa U Kalayci, Sinan Hatipoglu, Hakan Yigitbas, Ersan Aygun
Affiliations

Rectus sheath hematoma: three case reports

Selin Kapan et al. J Med Case Rep. .

Abstract

Introduction: Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen.

Case presentation: We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment.

Conclusion: Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.

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Figures

Figure 1
Figure 1
CT appearance of rectus hematoma on the right upper abdomen.
Figure 2
Figure 2
US appearance misdiagnosed as intestinal obstruction "Target sign".
Figure 3
Figure 3
CT appearance of rectus sheath hematoma on the left side of the abdomen.
See this image and copyright information in PMC

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