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Related Experiment Video

Updated: Nov 7, 2025

In situ Transverse Rectus Abdominis Myocutaneous Flap: A Rat Model of Myocutaneous Ischemia Reperfusion Injury
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Post-partum rectus sheath hematoma complication: case report.

Makenzy M Sufficool1, Iqra B Sheikh1,2, Robert E Shapiro1,2

  • 1West Virginia University School of Medicine, Morgantown, WV, USA.

AME Case Reports
|April 29, 2021
PubMed
Summary
This summary is machine-generated.

Rectus sheath hematomas (RSHs) are rare during pregnancy and can lead to serious complications. This case highlights a severe RSH with necrotizing fasciitis post-cesarean delivery, requiring surgical intervention.

Keywords:
Necrotizing fasciitiscase reportpost-partumrectus sheath hematoma (RSH)

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Pathology
  • Radiology

Background:

  • Rectus sheath hematomas (RSHs) are associated with pregnancy, surgery, and trauma.
  • The incidence and infectious complications of RSH during pregnancy are not well-documented.
  • Cesarean delivery is a known risk factor for RSH development.

Observation:

  • A 26-year-old postpartum patient presented with severe abdominal pain two weeks after a cesarean delivery.
  • Computed tomography (CT) scan revealed a large 15-cm rectus sheath hematoma.
  • Initial conservative management failed due to signs of infection.

Findings:

  • Exploratory laparotomy identified necrotizing fasciitis of the rectus muscle and subcutaneous tissue.
  • This represents an atypical and severe presentation of a rectus sheath hematoma post-cesarean delivery.
  • The case underscores the potential for RSH to become infected and progress to myonecrosis.

Implications:

  • Early diagnosis and intervention are critical for pregnant and postpartum patients with RSH.
  • Conservative management may be insufficient in pregnant/postpartum patients, necessitating prompt surgical consideration.
  • Increased clinical suspicion and understanding of RSH complications can reduce maternal morbidity and mortality.