Tuberc Respir Dis.  2010 Dec;69(6):480-482.

A Case of Rectus Sheath Hematoma Complicated with Hypovolemic Shock in a Critically-Ill Patient

• Shin HJ
• Kim YH
• Chi SY
• Ban HJ
• Kwon YS
• Oh IJ
• Kim KS
• Lim SC
• Kim YC
• Kim SO

Abstract

Rectus sheath hematoma (RSH) is a rare condition caused by hemorrhage into the rectus sheath. It is usually associated with severe cough, abdominal surgery, coagulopathy, and anticoagulation treatment. RSH can be difficult to diagnose and can be misdiagnosed as acute appendicitis, as diverticulitis, or as an ovarian mass. Although RSH usually presents as a benign condition, it can be life threatening, especially in the critically-ill patient. Here, we report a case of fatal RSH due to hypovolemic shock in a critically-ill 73-year-old woman, who had received heparin treatment due to acute myocardial infarction in the intensive care unit and who had been successfully treated by conservative management.

Keyword

Hematoma; Rectus Abdominis; Shock

MeSH Terms

Aged
Appendicitis
Cough
Diverticulitis
Female
Hematoma
Hemorrhage
Heparin
Humans
Hypovolemia
Intensive Care Units
Myocardial Infarction
Rectus Abdominis
Shock
Heparin

Figure

• 

  Figure 1 Abdominal CT shows a liquefaction of large amount of hematoma in right rectus abdominis muscle and adjacent right pelvic extraperitoneal space, without active bleeding (arrow).

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