Spontaneous rectus sheath hematoma as a complication of anticoagulant and antiplatelet therapy: a case report.

Spontaneous rectus sheath hematoma (RSH) is an uncommon and often clinically misdiagnosed cause of abdominal pain, characterized by a presence of blood within rectus muscle sheath, with palpable mass. Hemorrhage may originate from the epigastric artery and branches or directly from rectus sheath rup...

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Published inRecenti progressi in medicina Vol. 110; no. 2; p. 89
Main Authors Carlesi, Roberto Maria, Castoldi, Maria Chiara, Rampoldi, Antonio Gaetano, Incorvaia, Cristoforo, Centeleghe, Paola, Gatto, Gemma
Format Journal Article
LanguageItalian
Published Italy 01.02.2019
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Abstract Spontaneous rectus sheath hematoma (RSH) is an uncommon and often clinically misdiagnosed cause of abdominal pain, characterized by a presence of blood within rectus muscle sheath, with palpable mass. Hemorrhage may originate from the epigastric artery and branches or directly from rectus sheath rupture. The most frequent cause of hematoma is anticoagulant therapy. Diagnosis is based on ultrasonography and computed tomography. Conservative treatment and, in case of active bleeding, intravascular embolization is the treatment of choice, while surgery is indicated in case of failure of endovascular procedure or in patients with intra-abdominal rupture causing hemodynamic instability and abdominal compartment syndrome. Here we present a case of RSH that developed after hip replacement surgery in a patient on anticoagulant therapy and dual antiplatelet therapy.
AbstractList Spontaneous rectus sheath hematoma (RSH) is an uncommon and often clinically misdiagnosed cause of abdominal pain, characterized by a presence of blood within rectus muscle sheath, with palpable mass. Hemorrhage may originate from the epigastric artery and branches or directly from rectus sheath rupture. The most frequent cause of hematoma is anticoagulant therapy. Diagnosis is based on ultrasonography and computed tomography. Conservative treatment and, in case of active bleeding, intravascular embolization is the treatment of choice, while surgery is indicated in case of failure of endovascular procedure or in patients with intra-abdominal rupture causing hemodynamic instability and abdominal compartment syndrome. Here we present a case of RSH that developed after hip replacement surgery in a patient on anticoagulant therapy and dual antiplatelet therapy.
Author Centeleghe, Paola
Rampoldi, Antonio Gaetano
Carlesi, Roberto Maria
Castoldi, Maria Chiara
Incorvaia, Cristoforo
Gatto, Gemma
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  surname: Gatto
  fullname: Gatto, Gemma
  organization: UOC Cardiologia Riabilitativa CTO, ASST Gaetano Pini/CTO, Milano
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Title Spontaneous rectus sheath hematoma as a complication of anticoagulant and antiplatelet therapy: a case report.
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