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Obstructive uropathy secondary to rectus sheath hematoma
Pankaj P Dangle1, Mitesh B Patel, Marcos Terán
1Saint Louis University School of Medicine, Department of Surgery, Division of Urology, USA. pankajdangle@gmail.com
The West Virginia Medical Journal
|April 23, 2013
Summary
Rectus sheath hematoma (RSH), a rare abdominal condition, can cause severe complications. This case highlights RSH leading to obstructive anuria and hydronephrosis, emphasizing its varied clinical presentations.
Area of Science:
- Abdominal imaging and diagnostics
- Vascular emergencies
- Urology
Background:
- Rectus sheath hematoma (RSH) is an uncommon condition, frequently associated with anticoagulation therapy or abdominal trauma.
- Standard presentations include abdominal pain and a palpable abdominal wall mass.
- Diverse clinical manifestations and complications can arise based on hematoma size and patient factors.
Observation:
- A case of a rapidly expanding rectus sheath hematoma (RSH) is presented.
- The hematoma's expansion led to significant urinary tract obstruction.
- This resulted in obstructive anuria and hydronephrosis.
Findings:
- The rectus sheath hematoma caused bilateral ureteral compression, leading to obstructive anuria.
- Imaging confirmed significant hydronephrosis secondary to the hematoma.
- Literature review identified this as a rare but serious complication of RSH.
Implications:
- This case underscores the importance of considering RSH in patients presenting with abdominal masses and acute urinary symptoms.
- Prompt diagnosis and management are crucial to prevent renal damage from obstructive anuria.
- Awareness of RSH's potential to cause urinary obstruction can improve patient outcomes.
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