1/6. Rectus sheath hematoma.We describe 3 patients with rectus sheath hematoma presenting to the emergency department. Prompt consideration of this uncommon cause of abdominal pain may prevent more expensive and invasive diagnostic tests and, in some cases, unnecessary hospitalization and laparotomy.- - - - - - - - - - ranking = 1keywords = sheath (Clic here for more details about this article) |
2/6. Rectus sheath hematoma in an elderly woman under anti-coagulant therapy.Rectal sheath hematoma has been a well-known clinical entity from the ruin of the ancient greece. It is relatively rare, however, to encounter this abdominal disorder in the clinical setting. Furthermore, the initial symptoms of rectus sheath hematoma are often similar to those of acute abdominal disorders. Therefore, the majority of the patients with rectus sheath hematoma have been treated with operative procedures because of the difficulty of a differential diagnosis from other abdominal disorders. We recently treated a 74-year female diagnosed with rectus sheath hematoma with the anticoagulants after an episode of cerebral infarction. From the findings of the physical examinations, ultrasound, and computed tomography, we could correctly diagnose, and could treat her with completely conservative methods without any invasive techniques. It is stressed that it is important to recognize this entity of rectus sheath hematoma when patients are examined, after complaining of acute abdominal pain and with evidence abdominal masses in the clinical setting.- - - - - - - - - - ranking = 1.8keywords = sheath (Clic here for more details about this article) |
3/6. Spontaneous hematoma of the rectus abdominis muscle: a rare cause of acute abdominal pain in the elderly.A rectus abdominis sheath hematoma (RSH) is uncommon. It may mimic other acute abdominal disorders. The underlying conditions are trauma, coagulation disorders, or anticoagulant therapy, complications related to operations, subcutaneous injections to the abdominal wall, although it can also develop spontaneously. Acute abdominal pain and a palpable mass after muscular strain such as coughing, sneezing, and twisting were features highly suggestive of RSH. The diagnostic means of choice is computerized tomography. The treatment is usually conservative, but surgery may be needed in cases with large or progressing hematomas or with severe symptoms. We herein report an elderly woman presenting with an acute painful abdominal mass, without any underlying conditions, which was diagnosed as spontaneous RSH. She needed an operation. We concluded that RSH should be considered in the differential diagnosis of acute abdominal pain in the elderly, even in the absence of underlying conditions.- - - - - - - - - - ranking = 0.2keywords = sheath (Clic here for more details about this article) |
4/6. syndrome of the rectus abdominis muscle mimicking the acute abdomen.The syndrome of the rectus abdominis muscle is a disorder of unknown etiology that produces rupture or tear of the epigastric artery, and stretches the rectus cutaneous medialis nerve, producing excruciating pain. The disorder is misdiagnosed in 60% to 93% of cases. We report two cases that presented as acute abdomen. One helpful diagnostic test was the lidocaine test, accomplished by subcutaneous injection of lidocaine into the sheath of the rectus abdominis muscle near the rectus cutaneous medialis nerve; the procedure provided immediate pain relief and the patients remained asymptomatic. In addition to helping establish a diagnosis quickly the lidocaine test may spare the patient the unnecessary morbidity or mortality of more invasive procedures.- - - - - - - - - - ranking = 0.2keywords = sheath (Clic here for more details about this article) |
5/6. Rectus sheath hematoma: diagnosis by computed tomography scanning.A 65-year-old woman receiving long-term oral anticoagulant therapy was admitted with signs and symptoms suggesting colonic obstruction. A tender, firm left lower-quadrant mass, colonic and small bowel distention, mild leukocytosis, and a markedly elevated prothrombin time were the prominent presenting abnormalities. Emergency colon x-ray study did not demonstrate colonic obstruction, and ultrasound of the abdomen was initially nondiagnostic. Computed tomography scanning revealed a large mass localized in the left rectus sheath and muscle consistent, in this clinical setting, with a spontaneous rectus sheath hematoma. The purpose of this report is to suggest the usefulness of computed tomography scanning in the evaluation of indeterminate abdominal masses such as the rectus sheath hematoma. The subject of rectus sheath hematoma is reviewed to emphasize its inclusion in the differential diagnosis of the acute abdomen and to suggest an earlier, more accurate, and noninvasive approach to its diagnosis.- - - - - - - - - - ranking = 1.6keywords = sheath (Clic here for more details about this article) |
6/6. Spontaneous rectus sheath hematoma during pregnancy mimicking abruptio placenta.Sudden disruption of a deep epigastric vessel may result in an abdominal wall hematoma, which, depending upon its location and size, can produce symptoms and clinical findings compatible with a variety of acute intra-abdominal conditions. The literature has noted a predominance of pregnant patients among those affected with this malady. Such hematomas are infrequently encountered and early accurate diagnosis could prevent surgical intervention. Unfortunately, the clinical manifestations of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed under the belief that intra-abdominal pathology is present. We present a case of a suspected abruptio placenta misdiagnosed by clinical and ultrasound examination that was subsequently discovered to be a rectus sheath hematoma at the time of surgery.- - - - - - - - - - ranking = 1keywords = sheath (Clic here for more details about this article) |