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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.

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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.