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Spontaneous rectus sheath hematomas: clinical and radiological features
T Fukuda1, I Sakamoto, S Kohzaki
1Department of Radiology, Nagasaki University School of Medicine, Japan.
Abdominal Imaging
|January 1, 1996
Summary
Spontaneous rectus sheath hematoma (RSH) in elderly adults presents with abdominal pain and masses after strain. Imaging like CT and MRI aids diagnosis, distinguishing RSH from other conditions.
Area of Science:
- Radiology
- Gastroenterology
- Geriatrics
Background:
- Spontaneous rectus sheath hematoma (RSH) is a rare condition, often affecting elderly individuals.
- Clinical presentation can mimic other acute abdominal pathologies, leading to diagnostic challenges.
Purpose of the Study:
- To review the clinical and radiological features of spontaneous rectus sheath hematoma (RSH).
- To highlight diagnostic clues and imaging characteristics of RSH.
Main Methods:
- Retrospective review of eight elderly patients diagnosed with spontaneous RSH.
- Analysis of clinical presentations, surgical findings, and radiological imaging (ultrasound, CT, MRI).
Main Results:
- Four patients had RSH confirmed surgically, while four experienced spontaneous resolution.
- Suggestive clinical features include acute abdominal pain and a palpable mass post-muscular strain.
- CT scans show a characteristic hyperdense mass with muscular enlargement in acute RSH; chronic RSH may have variable density.
- MRI is highly effective, showing high signal intensity on T1- and T2-weighted images, especially when CT is non-specific.
Conclusions:
- Spontaneous RSH in the elderly requires a high index of suspicion based on clinical presentation.
- Radiological imaging, particularly MRI, plays a crucial role in accurate diagnosis and differentiation from other abdominal masses.