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Related Concept Videos

Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
Intestinal Obstruction I: Introduction01:29

Intestinal Obstruction I: Introduction

Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...

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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
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Published on: October 15, 2021

Cough-induced internal oblique hematoma.

Koichi Kodama1, Yasukazu Takase, Hiroki Yamamoto

  • 1Department of Urology, Toyama City Hospital, Toyama, Japan.

Journal of Emergencies, Trauma, and Shock
|June 1, 2013
PubMed
Summary

Severe coughing can cause abdominal wall hematomas, a rare musculoskeletal complication. This case highlights a cough-induced internal oblique hematoma in an obese elderly woman, emphasizing the need for clinical suspicion.

Keywords:
Abdominal wall hematomacomputed tomographycoughinternal oblique muscleultrasonography

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Area of Science:

  • Musculoskeletal Complications
  • Abdominal Wall Pathology
  • Medical Case Reports

Background:

  • Sustained or violent coughing is a known, albeit uncommon, cause of musculoskeletal injury.
  • Abdominal wall hematomas are typically associated with trauma or anticoagulant use.
  • This report focuses on a non-traumatic, non-anticoagulated patient presenting with cough-induced hematoma.

Observation:

  • A 73-year-old obese female presented with acute right flank pain.
  • The patient reported a month of continuous cough, with severe coughing preceding pain onset.
  • Imaging revealed a significant hematoma within the right internal oblique muscle.

Findings:

  • Ultrasonography identified a hypoechoic mass in the right lateral abdominal wall.
  • Computed tomography confirmed a 7 cm × 7 cm × 4 cm hematoma in the internal oblique muscle.
  • The patient was managed conservatively without requiring blood transfusion.

Implications:

  • Acute abdominal pain and a palpable abdominal mass in coughing patients warrant consideration of abdominal wall hematoma.
  • This case expands the differential diagnosis for abdominal pain in the context of severe coughing.
  • Physicians should maintain a high index of suspicion for this rare complication, even in the absence of trauma or anticoagulation.