Spontaneous Rectus Sheath Hematoma: an Overview of 4-Year Single Center Experience
Tóm tắt
Rectus sheath hematoma is a clinical entity characterized by the presence of blood within rectus abdominis muscle sheath. The aim of this study was to analyze clinical characteristics, diagnostic approach, treatment strategy, and outcomes of patients with rectus sheath hematoma. Patients diagnosed and treated for spontaneous rectus sheath hematoma between March 2010 and March 2014 were included in the study. A total of 10 patients were diagnosed as spontaneous rectus sheath hematoma. The mean age was 66.5 ± 16.9 years, and the mean hospital stay was 4.4 ± 1.8 days. There was no mortality. Six patients were using anticoagulant or antiplatelet agents. Eight patients recovered after conservative treatment. Two patients underwent surgery. Spontaneous rectus sheath hematoma is associated with anticoagulant therapy. Cases with abdominal pain and a non-pulsatile abdominal mass particularly in elderly women should be kept in mind. Treatment is mostly based on supportive care to preserve hemodynamic stability.
Tài liệu tham khảo
Siu WT, Tang CN, Law BK, Chau CH, Li MK (2003) Spontaneous rectus sheath hematoma. Can J Surg 46:390
Alla VM, Karnam SM, Kaushik M, Porter J (2010) Spontaneous rectus sheath hematoma. West J Emerg Med 11:76–9
Klingler PJ, Oberwalder MP, Riedmann B, DeVault KR (2000) Rectus sheath hematoma clinically masquerading as sigmoid diverticulitis. Am J Gastroenterol 95:555–6
Bene J, Lassman D, Solomon SA (1998) Rectus sheath haematoma in elderly patients: a diagnostic challenge. Age Ageing 27:512–4
Osinbowale O, Bartholomew JR (2008) Rectus sheath hematoma. Vasc Med 13:275–9
Donaldson J, Knowles CH, Clark SK, Renfrew I, Lobo MD (2007) Rectus sheath haematoma associated with low molecular weight heparin: a case series. Ann R Coll Surg Engl 89:309–12
Kapan S, Turhan AN, Alis H, Kalayci MU, Hatipoglu S, Yigitbas H et al (2008) Rectus sheath hematoma: three case reports. J Med Case Rep 2:22
Dag A, Ozcan T, Turkmenoglu O, Colak T, Karaca K, Canbaz H et al (2011) Spontaneous rectus sheath hematoma in patients on anticoagulation therapy. Ulus Travma Acil Cerrahi Derg 17:210–4
Costello J, Wright J (2005) Rectus sheath haematoma: a diagnostic dilemma? Emerg Med J 22:523–4
Carnett J (1926) Intercostal neuralgia as a cause of abdominal pain and tenderness. Surg Gynecol Obstet 625–32
Cherry WB, Mueller PS (2006) Rectus sheath hematoma: review of 126 cases at a single institution. Medicine 85:105–10
Moreno Gallego A, Aguayo JL, Flores B, Soria T, Hernandez Q, Ortiz S et al (1997) Ultrasonography and computed tomography reduce unnecessary surgery in abdominal rectus sheath hematoma. Br J Surg 84:1295–97
Dubinsky IL (1997) Hematoma of the rectus abdominis muscle: case report and review of the literature. J Emerg Med 15:165–7
Adeonigbagbe O, Khademi A, Karowe M, Gualtieri N, Robilotti J (2000) Spontaneous rectus sheath hematoma and an anterior pelvic hematoma as a complication of anticoagulation. Am J Gastroenterol 95:314–5
Ozaras R, Yilmaz MH, Tahan V, Uraz S, Yigitbasi R, Senturk H (2003) Spontaneous hematoma of the rectus abdominis muscle: a rare cause of acute abdominal pain in the elderly. Acta Chir Belg 103:332–3
Fitzgerald JE, Fitzgerald LA, Anderson FE, Acheson AG (2009) The changing nature of rectus sheath haematoma: case series and literature review. Int J Surg 7:150–4
Salemis NS, Gourgiotis S, Karalis G (2010) Diagnostic evaluation and management of patients with rectus sheath hematoma. A retrospective study. Int J Surg 8:290–3
Zissin R, Gayer G, Kots E, Ellis M, Bartal G, Griton I (2007) Transcatheter arterial embolisation in anticoagulant-related haematoma—a current therapeutic option: a report of four patients and review of the literature. Int J Clin Pract 61:1321–7