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Rectus sheath hematoma: a diagnostic dilemma
1Department of Obstetrics and Gynaecology, Royal Commission Medical Centre, Saudi Arabia. azizdrshaista@yahoo.com
Summary
Rectus sheath hematoma can mimic obstetrical emergencies. Misdiagnosis occurred despite clinical and ultrasound exams, with the condition only identified during surgery.
Area of Science:
- Obstetrics and Gynecology
- Abdominal Surgery
- Emergency Medicine
Background:
- Rectus sheath hematoma (RSH) is a rare cause of acute abdominal pain.
- It can mimic various intra-abdominal pathologies, posing diagnostic challenges.
Observation:
- A case presented as an obstetrical emergency.
- Initial suspicion included degenerating uterine fibroid, abruptio placenta, or uterine rupture.
- Clinical and ultrasound examinations led to misdiagnosis.
Findings:
- Emergency laparotomy revealed the patient had a rectus sheath hematoma.
- The hematoma was the primary cause of the acute abdominal presentation.
Implications:
- Highlights the importance of considering RSH in acute abdominal conditions, even in obstetrical emergencies.
- Underscores limitations of clinical and ultrasound diagnostics in certain RSH presentations.
- Suggests a need for heightened awareness among clinicians managing acute abdominal pain in pregnancy.
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