ORIGINAL ARTICLE
A Conservative Approach to Rectus Sheath
Haematomas
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Dicle University Medical Faculty, Diyarbakır, Turkey
Publication date: 2011-07-11
Corresponding author
Akın Önder
Dicle Universitesi, Tıp Fakültesi
Genel Cerrahi AD. 21280, Diyarbakır,
Turkey
Eur J Gen Med 2011;8(3):224-228
KEYWORDS
ABSTRACT
Aim: Rectus sheath haematoma (RSH) is the result of a rupture of
epigastric vessels or rectus muscle occurring mostly in infraumblical
region. Etiological factor is predominantly trauma and rarely spontaneous.
Generally, misdiagnosed or delays in diagnosis result in unnecessary
surgical intervention.
Method: Between December 2008 and September 2009, five patients
diagnosed for RSH in our hospital retrospectively analyzed in terms of
the demographical characteristics, clinical and radiological findings
and length of stay in hospital.
Result: The average age of the patients was 67 (59-76) years and all
were female. At least one of the patients had a systematic disease. All
the patients were using anticoagulant and none of them had trauma
story. On physical examination, we determined palpable masses loca
ted as follows; in left lower quadrant of three patients, in right lower
quadrant of one patient and in left upper quadrant of one patient.
The types of RSH in radiological imaging were Type 1 in one patient,
Type 2 in three patients and Type 3 in one patient. Anticoagulant
treatments were stopped and all patients were treated conservatively.
The average stay in hospital time of the patients was 8 days. The
computed tomography control at the end of the first month revealed
that the mass disappeared in cases with Type 1 RSH while the other
four cases had a marked decrease in the mass size.
Conclusion: RSH should be taken into consideration in differential
diagnosis when elder patients – especially females – with anemia, palpable
mass, anticoagulant medication history admitted to clinics with
acute abdomen. Early diagnosis of RSH provides the preventing of the
unnecessary surgical interventions and determines the success of conservative
treatment.