Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-10T11:15:27.207Z Has data issue: false hasContentIssue false
  • English
  • Français

Spontaneous rectus sheath hematoma diagnosed by point-of-care ultrasonography

Published online by Cambridge University Press:  04 March 2015

Hamid Shokoohi ,
Keith Boniface ,
M. Reza Taheri  and
Ali Pourmand
Hamid Shokoohi*
Affiliation:
Department of Emergency Medicine, George Washington University Medical Center, Washington, DC
Keith Boniface
Affiliation:
Department of Emergency Medicine, George Washington University Medical Center, Washington, DC
M. Reza Taheri
Affiliation:
Department of Radiology, George Washington University Medical Center, Washington, DC
Ali Pourmand
Affiliation:
Department of Emergency Medicine, George Washington University Medical Center, Washington, DC
*
Department of Emergency Medicine, George Washington University Medical Center, 2150 Pennsylvania Avenue, NW, Suite 2B, Washington, DC 20037; hshokoohi@mfa.gwu.edu, hshokoohi@gmail.com

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Spontaneous rectus sheath hematoma is an uncommon condition that can mimic other conditions associated with an acute abdomen. We report the case of a patient with a spontaneous rectus sheath hematoma due to a ruptured inferior epigastric artery pseudoaneurysm who presented with hypotension and severe abdominal pain and was diagnosed using emergency department point-of-care ultrasonography. Point-of-care ultrasonography has been increasingly used in the evaluation of emergency department patients with acute abdomen and hypotension to expedite the diagnosis and management of aortic aneurysm and intraperitoneal bleeding. Resuscitation and urgent surgical and interventional radiology consultations resulted in the successful embolization of a branch of the inferior epigastric artery and a good outcome.

Keywords

inferior epigastric artery rupturerectus sheath hematomaultrasonography
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 15 , Issue 2 , March 2012 , pp. 120 - 123
Copyright
Copyright © Canadian Association of Emergency Physicians 2013

References

REFERENCES

1.Oh, JM, Kim, TH, Cha, SJ, et al. Rectus sheath hematoma caused by non-contact strenuous exercise mimicking acute appendicitis. J Emerg Med 2010;39:e117-9, doi:10.1016/j.jemermed.2007.10.088.CrossRefGoogle ScholarPubMed
2.Ozucelik, DN, Yucel, N, Emet, M, et al. Spontaneous rectus sheath hematoma presenting with acute abdominal pain: a case series and review of the literature. Ann Saudi Med 2005;25:250–4.CrossRefGoogle ScholarPubMed
3.Donaldson, J, Knowles, CH, Clark, SK, et al. Rectus sheath haematoma associated with low molecular weight heparin: a case series. Ann R Coll Surg Engl 2007;89:309–12, doi:10.1308/003588407X179152.Google Scholar
4.Klingler, PJ, Wetscher, G, Glaser, K, et al. The use of ultrasound to differentiate rectus sheath hematoma from other acute abdominal disorders. Surg Endosc 1999;13:1129–34, doi:10.1007/s004649901188.Google Scholar
5.Moreno Gallego, A, Aguayo, JL, Flores, B, et al. Ultrasonography and computed tomography reduce unnecessary surgery in abdominal rectus sheath haematoma. Br J Surg 1997;84:1295–7, doi:10.1046/j.1365-2168.1997.02803.x.Google Scholar
6.Cherry, WB, Mueller, PS. Rectus sheath hematoma: review of 126 cases at a single institution. Medicine (Baltimore) 2006;85:105–10, doi:10.1097/01.md.0000216818.13067.5a.Google Scholar
7.Luhmann, A, Williams, EV. Rectus sheath hematoma: a series of unfortunate events. World J Surg 2006;30:2050–5, doi:10.1007/s00268-005-0702-9.Google Scholar
8.Auten, JD, Schofer, JM, Banks, SL, et al. Exercise-induced bilateral rectus sheath hematomas presenting as acute abdominal pain with scrotal swelling and pressure: case report and review. J Emerg Med 2010;38(3):e9–12, doi:10.1016/j.jemermed.2007.06.027.Google Scholar
9.Georgiadis, GS, Souftas, VD, Papas, TT, et al. Inferior epigastric artery false aneurysm: review of the literature and case report. Eur J Vasc Endovasc Surg 2007;33:182–6, doi:10.1016/j.ejvs.2006.08.006.Google Scholar
10.Ortega-Carnicer, J, Ceres, F. Rectus sheath haematoma with severe haemodynamic compromise after enoxaparin use for unstable angina. Resuscitation 2003;57:113–4, doi:10.1016/S0300-9572(02)00431-8.CrossRefGoogle ScholarPubMed
11.Wyatt, GM, Spitz, HB. Ultrasound in the diagnosis of rectus sheath hematoma. JAMA 1979;241:1499–500, doi:10.1001/jama.1979.03290400059029.CrossRefGoogle ScholarPubMed
12.Berna, JD, Garcia-Medina, V, Guirao, J, et al. Rectus sheath hematoma: diagnostic classification by CT. Abdom Imaging 1996;21:62–4, doi:10.1007/s002619900011.Google ScholarPubMed
13.Day, CM, Sodickson, A. The art and science of straight lines in radiology. AJR Am J Roentgenol 2011;196:W166-73, doi:10.2214/AJR.10.4446.Google Scholar