[Rectus sheath haematoma: experience in our centre].

Area of Science:

• Medical research
• Clinical diagnostics
• Patient management

Background:

• Spontaneous rectus sheath hematoma (RSH) is a rare but significant cause of abdominal pain.
• Understanding RSH's clinical profile, risk factors, and treatment is crucial for effective patient care.

Purpose of the Study:

• To characterize clinical features of RSH patients.
• To identify predisposing and precipitating factors for RSH.
• To evaluate therapeutic management strategies for RSH.

Main Methods:

• A retrospective descriptive study analyzed 46 cases of RSH diagnosed between 2002 and 2016.
• Data collected included epidemiological, clinical, diagnostic, and treatment information.
• Statistical analysis was performed to identify significant associations.

Main Results:

• The study population median age was 81 years, with 61% females.
• Common triggers included persistent coughing and low molecular weight heparin injections; 70% of patients were on anticoagulation, often supratherapeutically.
• Conservative management was most frequent, but larger hematomas and higher transfusion needs correlated with longer hospital stays and increased invasive interventions (interventional radiology or surgery).

Conclusions:

• RSH predominantly affects elderly patients, frequently associated with supratherapeutic anticoagulation (e.g., acenocumarol), often leading to therapy suspension.
• Renal insufficiency is linked to anticoagulant overdosage and hematoma formation.
• Hematoma size and transfusion requirements appear to predict the need for invasive procedures like arterial embolization or surgery.