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Nephrotic syndrome with rectus sheath hematoma: a case report
Ai Fujii1,2, Yuto Matsuda2, Tomohisa Yabe1
1Department of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan.
Journal of Medical Case Reports
|March 9, 2024
Summary
Rectus sheath hematoma, a rare condition, can occur without trauma in patients with nephrotic syndrome. Conservative management led to significant improvement, highlighting its potential in at-risk individuals.
Area of Science:
- Nephrology
- Vascular Surgery
- Internal Medicine
Background:
- Rectus sheath hematoma (RSH) is uncommon, typically linked to abdominal trauma or anticoagulant use.
- Nephrotic syndrome is a risk factor for vascular complications, including RSH.
Observation:
- A 72-year-old woman with nephrotic syndrome, on steroid and anticoagulant therapy, presented with abdominal pain.
- Abdominal CT confirmed a spontaneous rectus sheath hematoma.
Findings:
- The patient received conservative management, including transfusion and bed rest.
- Significant clinical improvement in abdominal pain was observed without invasive intervention.
Implications:
- RSH should be considered in patients with risk factors like anticoagulant/steroid therapy, advanced age, or nephrotic syndrome, even without trauma.
- Conservative management may be effective for rectus sheath hematoma in select high-risk patients.
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