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Case Reports
. 2023 Aug 25;15(8):e44138.
doi: 10.7759/cureus.44138. eCollection 2023 Aug.

Spontaneous Rectus Sheath Hematoma

Snehasis Das  1 , Sagar Prakash  1 , Shweta Singh  2 , Oseen Shaikh  1 , Gopal Balasubramanian  1
Affiliations
Case Reports

Spontaneous Rectus Sheath Hematoma

Snehasis Das et al. Cureus. .

Abstract

Rectus sheath hematoma (RSH) is one of the surgical emergencies that mimics peritonitis or other causes of acute abdominal pain. It is usually seen in old age, post-trauma, anticoagulation therapy pregnancy, chronic cough, and liver disease. Nevertheless, RSHs can be spontaneous without any underlying predisposing factors. Here, we present a 51-year-old female with sudden onset abdominal pain, abdominal distention, hypotension, and severe pallor. After initial resuscitation, the patient underwent radiological imaging. This suggested an RSH with active bleeding from the inferior epigastric artery or profunda femoris artery. The patient underwent digital subtraction angiography and angioembolization of the profunda femoris branch. After a few days, the patient continued deteriorating and succumbed to acute respiratory distress syndrome (ARDS).

Keywords: angioembolization; digital subtraction angiography; inferior epigastric artery; profundal femoris artery; rectus sheath hematoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Clinical picture showing infraumbilical rectus sheath hematoma (arrow).
Figure 2
Figure 2. Computed tomography image (axial view) showing. A: Two well-defined hematomas in the right and left supra-umbilical region abutting the parietal peritoneum (arrows). B: The right rectus abdominis muscle appears bulky with an ill-defined hypodense rectus sheath hematoma (arrow).
Figure 3
Figure 3. Digital subtraction angiography. A: Common iliac artery with a catheter inside (yellow arrow), external iliac artery (red arrow), and internal iliac artery (blue arrow). B: Superficial femoral artery (red arrow) and profunda femoris artery (yellow arrow). C: Catheter inside the branch of the profunda femoris artery (yellow arrow)which shows blush (blue arrow). D: Profunda femoris artery (red arrow) with a catheter inside the branch of it (yellow arrow) and employed branch without any more blush (blue arrow).
See this image and copyright information in PMC

References

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