Rectus Sheath Hematoma Mimicking Acute Abdomen in Stroke Rehabilitation: A Case Report

Yıl 2023, Cilt: 8 Sayı: 4, 74 - 76, 05.12.2023

Rukiye Akay , Havva Talay Çalış , Fatma Gül Ülkü Demir

https://doi.org/10.55694/jamer.1367587

Öz

Rectus sheath hematoma is a rare condition that results from bleeding into the rectus sheath of the epigastric arteries
and sometimes mimics acute abdomen. Anticoagulant therapy is a major risk factor for hemorrhagic events. Trauma,
hematological disorders, severe coughing, and strenuous physical exercise are other predisposing factors. It is generally
a self-limiting condition, and conservative treatment is often sufficient. The purpose of this case presentation is to
discuss the physical examination and clinical findings of a patient who developed rectus sheath hematoma mimicking
acute abdomen during stroke rehabilitation.

Anahtar Kelimeler

Rectus sheath hematoma, stroke, physical exercise

İnme Rehabilitasyonunda Akut Batını Taklit Eden Rektus Kılıf Hematomu: Vaka Sunumu

Öz

Rektus kılıfı hematomu, epigastrik arterlerin rektus kılıfına kanaması sonucu ortaya çıkan ve bazen akut karını taklit
edebilen nadir bir durumdur. Antikoagülan tedavi hemorajik olaylar için ana risk faktörlerindendir. Travma, hematolojik hastalıklar, şiddetli öksürük, ağır fiziksel egzersiz gibi durumlar ise diğer predispozan nedenlerdir. Genellikle kendi
kendini sınırlayan bir durumdur ve çoğu zaman konservatif tedavi yeterli olmaktadır. Bu olgu sunumunda amacımız;
İnme rehabilitasyonu sırasında akut batını taklit eden rektus kılıf hematomu gelişen hastanın fizik muayene ve klinik
bulgularını tartışmaktır.

Anahtar Kelimeler

inme, rektus kılıf hematomu, fiziksel egzersiz

Kaynakça

• 1. Hatjipetrou A, Anyfantakis D, Kastanakis M. Rectus sheath hematoma: a review of the literature. Int J Surg. 2015;13:267-71. doi:10.1016/j.ijsu.2014.12.015.
• 2. De Martino C, Martino A, Giamattei RM, Viola G, Pisapia A, Fatigati G. Ematoma spontaneo del muscolo retto addominale: evenienza rara, diagnosi difficile e trattamento multidisciplinare. Presentazione di 5 casi clinici e revisione della letteratura [Spontaneous rectus sheath hematoma: a rare condition with uneasy diagnosis and multidisciplinary treatment. Report of 5 cases and review of literature]. Ann Ital Chir. 2011;82(5):399-404.
• 3. Samadov E, Ibrahimli A, Mamishov S. Rectus sheath hematoma secondary to domestic violence. Cureus. 2021;10;13(8):e17058. doi:10.7759/cureus.17058.
• 4. Mahmoudabadi HZ, Hadadi A, Fattahi MR, Kafan S, Ashouri M, Allahbeigi R, Hajebi R. Rectus sheath hematoma in COVID-19 patients as a mortal complication: A retrospective report. Int J Clin Pract. 2022;12;2022:7436827. doi: 10.1155/2022/7436827.
• 5. Cocco G, Ricci V, Boccatonda A, Stellin L, De Filippis G, Soresi M, Schiavone C. Sonographic demonstration of a spontaneous rectus sheath hematoma following a sneeze: a case report and review of the literature. J Ultrasound. 2021;24(2):125-30. doi: 10.1007/s40477- 020-00493-4.
• 6. Ozucelik DN, Neslihan Y, Emet M, Coskun S. Spontaneous rectus sheath hematoma presenting with acute abdominal pain: a case series and review of the literature. Ann Saudi Med. 2005;25(3):250-4. doi: 10.5144/0256-4947.2005.250.
• 7. Drinnon K, Simpson SS, Puckett Y, Ronaghan CA, Richmond RE. Rectus sheath hematoma: a rare surgical emergency. Cureus. 2020;12(12):e12156. doi: 10.7759/cureus.12156.
• 8. Klingler PJ, Wetscher G, Glaser K, Tschmelitsch J, Schmid T, Hinder RA. The use of ultrasound to differentiate rectus sheath hematoma from other acute abdominal disorders. Surg Endosc. 1999;13(11):1129-34. doi: 10.1007/s004649901188.
• 9. Zengin K, Carkman S, Kiliç I, Beken E, Eyüboğlu E. Rektus kılıf hematomu olgularina yaklaşımımız [Treatment approaches to rectus sheath hematoma]. Ulus Travma Acil Cerrahi Derg. 2007;13(1):55-9
• 10. Sheth HS, Kumar R, DiNella J, Janov C, Kaldas H, Smith RE. Evaluation of risk factors for rectus sheath hematoma. Clin Appl Thromb Hemost. 2016;22(3):292-6.
• 11. Cherry WB, Mueller PS. Rectus sheath hematoma: Review of 126 cases at a single institution. Medicine (Baltimore). 2006;85(2):105-10
• 12. Allen M, Sevensma KE. Rectus sheath hematoma. 2023 Jan 30. In: statPearls [Internet]. Treasure Island (FL): StatPearls Publishing;2023
• 13. Liao ED, Puckett Y. A Proposed algorithm on the modern management of rectus sheath hematoma: A literature review. Cureus.2021;13(11):e20008.
• 14. Rimola J, Perendreu J, Falcó J, Fortuño JR, Massuet A, Branera J. Percutaneous arterial embolization in the management of rectus sheath hematoma. AJR Am J Roentgenol. 2007;188(6):W497-502.