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01 October 2005

Small bowel infarction complicating rectus sheath haematoma in an anti-coagulated patient.

Robert A Dineen, Nina R Lewis, Nishath Altaf

Med Sci Monit 2005; 11(10): CS57-59 :: ID: 430314

Abstract

BACKGROUND: A rectus sheath haematoma is a difficult condition to diagnoseand is usually treated by conservative measures. However, significant sized haematomas can result insevere haemodynamic repercussions, especially in those patients with co-morbidities and anticoagulation.CASE REPORT: The case reported here is of a 68 year old anticoagulated patient with severe medical co-morbiditywho presented with abdominal pain and hypotension. An abdominal CT scan demonstrated a large rectus sheathhaematoma and small bowel infarction. The relationship between these two separate causes of an acuteabdomen is discussed and imaging findings are illustrated. CONCLUSIONS: A careful history and a highindex of suspicion are necessary to diagnose a rectus sheath haematoma. Further imaging such as CT maybe required and if diagnosed early enough, it should be treated aggressively based on the clinical findings.

Keywords: Hematoma - radiography, Intestine, Small - radiography, Ischemia - radiography, Muscular Diseases - radiography, Rectus Abdominis - radiography, Tomography, X-Ray Computed

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750