Antonino Buffone1, Guido Basile2, Mario Costanzo3, Massimiliano Veroux3, Lorenza Terranova3, Antonio Basile4, Valeriya Okatyeva3, Maria Teresa Cannizzaro5. 1. Section of Endocrine Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy. Electronic address: a.buffone@unict.it. 2. Section of Emergency and General Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy. 3. Section of Endocrine Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy. 4. Section of Radiology, Garibaldi Hospital, Catania, Italy. 5. Section of Radiology, Delta-LagoSanto Hospital, Ferrara, Italy.
Abstract
BACKGROUND/ PURPOSE: Rectus sheath hematoma (RSH) is a rare clinical entity. It can be mistaken for other intra-abdominal disorders, which can result in diagnostic and therapeutic difficulties. This study was undertaken to analyze the clinical presentation, diagnostic modalities, and management of patients affected with RSH. METHODS: Between January 2008 and June 2011, eight patients (5 men and 3 women with a mean age of 53 years) with RSH were evaluated according to demographic characteristics, clinical and radiological findings, and methods of treatment. RESULTS: Six patients developed RSH after anticoagulant therapy; one after local trauma, and one after laparoscopic intervention. Six patients were treated nonsurgically; one patient underwent embolization of the inferior epigastric artery and one underwent ligation of the bleeding vessel. The average hospital stay was 6 days. There were no mortality or thromboembolic complications. CONCLUSION: RSH is a rare nonneoplastic entity that is usually associated with abdominal trauma and/or anticoagulant therapy. The gold standard for diagnosis is computed tomography, and ultrasonography can be used in follow-up. The treatment of choice is nonsurgical therapy because RSH is a self-limited condition. Surgical intervention should be reserved for cases with hemodynamic instability.
BACKGROUND/ PURPOSE:Rectus sheath hematoma (RSH) is a rare clinical entity. It can be mistaken for other intra-abdominal disorders, which can result in diagnostic and therapeutic difficulties. This study was undertaken to analyze the clinical presentation, diagnostic modalities, and management of patients affected with RSH. METHODS: Between January 2008 and June 2011, eight patients (5 men and 3 women with a mean age of 53 years) with RSH were evaluated according to demographic characteristics, clinical and radiological findings, and methods of treatment. RESULTS: Six patients developed RSH after anticoagulant therapy; one after local trauma, and one after laparoscopic intervention. Six patients were treated nonsurgically; one patient underwent embolization of the inferior epigastric artery and one underwent ligation of the bleeding vessel. The average hospital stay was 6 days. There were no mortality or thromboembolic complications. CONCLUSION:RSH is a rare nonneoplastic entity that is usually associated with abdominal trauma and/or anticoagulant therapy. The gold standard for diagnosis is computed tomography, and ultrasonography can be used in follow-up. The treatment of choice is nonsurgical therapy because RSH is a self-limited condition. Surgical intervention should be reserved for cases with hemodynamic instability.
Authors: Stefano Di Pietro; Francesco Tiralongo; Carla Maria Desiderio; Francesco Vacirca; Stefano Palmucci; Francesco Giurazza; Massimo Venturini; Antonio Basile Journal: J Clin Med Date: 2022-02-25 Impact factor: 4.241