Case report

Rectus sheath hematoma: three case reports

Selin Kapan , Ahmet N Turhan , Halil Alis , Mustafa U Kalayci , Sinan Hatipoglu , Hakan Yigitbas and Ersan Aygun

Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of General Surgery, Istanbul, Turkey

author email corresponding author email

Journal of Medical Case Reports 2008, 2:22doi:10.1186/1752-1947-2-22

Published:	25 January 2008

Abstract

Introduction

Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen.

Case presentation

We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment.

Conclusion

Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.