J Electrodiagn Neuromuscul Dis.  2022 Aug;24(2):38-41. 10.18214/jend.2022.00038.

Rectus Sheath Hematoma after Contralateral Intercostal Neuropathy as a Complication of Video-Assisted Thoracoscopic Surgery in a Patient with Asthma: A Case Report

• Gu M
• Oh MW
• Kim HT
• Kong HH

• KMID: 2535381
• DOI: http://doi.org/10.18214/jend.2022.00038

Abstract

Rectus sheath hematoma (RSH) in patients who have undergone video-assisted thoracoscopic surgery (VATS) has not been reported to date. This report describes a case of RSH in a patient with right abdominal muscle atrophy due to an intercostal nerve injury following VATS. A 61-year-old male patient complained of a bulge in the right upper abdominal quadrant after undergoing VATS. Computed tomography (CT) revealed atrophied right abdominal muscles, including the rectus abdominis, and the electrodiagnostic findings were compatible with right 8th and 9th intercostal neuropathy. The patient visited the emergency room 444 days after undergoing VATS, complaining of a left abdominal mass and pain. He had a severe cough 2 weeks prior due to underlying asthma. CT revealed an RSH in the left abdomen that shrank after 4 weeks of observation. In cases of abdominal muscle weakness due to intercostal neuropathy following VATS, the precipitating factors for RSH must be managed thoroughly.

Keyword

Video-assisted thoracoscopic surgery; Rectus abdominis; Hematoma