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Related Experiment Videos

Rectus sheath hematoma: diagnosis by computed tomography scanning.

J E Gocke, R L MacCarty, W T Foulk

    Mayo Clinic Proceedings
    |December 1, 1981
    PubMed
    Summary

    A spontaneous rectus sheath hematoma can mimic colonic obstruction in patients on anticoagulation. Computed tomography (CT) scanning is crucial for accurate diagnosis of these abdominal masses.

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    Area of Science:

    • Abdominal Imaging
    • Gastroenterology
    • Emergency Medicine

    Background:

    • Patients on long-term oral anticoagulation therapy are at increased risk for bleeding complications.
    • Abdominal masses can present with symptoms mimicking acute abdominal conditions, posing diagnostic challenges.

    Observation:

    • A 65-year-old woman on anticoagulation presented with signs of colonic obstruction, including a palpable mass and abdominal distention.
    • Initial investigations including colon x-ray and ultrasound were inconclusive.
    • Computed tomography (CT) scanning identified a large mass in the rectus sheath, consistent with spontaneous rectus sheath hematoma.

    Findings:

    • Spontaneous rectus sheath hematoma can present as an acute abdomen, mimicking other serious conditions like colonic obstruction.
    • CT scanning offers a noninvasive and accurate method for diagnosing rectus sheath hematoma.

    Implications:

    • CT scanning should be considered in the differential diagnosis of indeterminate abdominal masses, especially in anticoagulated patients.
    • Early and accurate diagnosis of rectus sheath hematoma can prevent unnecessary surgical interventions.
    • This case highlights the importance of considering spontaneous rectus sheath hematoma in the differential diagnosis of acute abdominal pain.

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