Management of spontaneous rectus sheath haematoma: Experience of double center
Acta Medica Mediterranea, cilt.30, sa.4, ss.811-814, 2014 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 4
- Basım Tarihi: 2014
- Dergi Adı: Acta Medica Mediterranea
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.811-814
- Anahtar Kelimeler: Rectus sheath, haematoma, conservative, coagulation, spontaneous
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Introduction: Rectus sheath hematoma (RSH) is an uncommon and often clinically misdiagnosed cause of abdominal pain. The most frequent predisposing factor is anticoagulation therapy and coughing, in fact it has been implicated as the most important precipitating risk factor. Early diagnosis could prevent unnecessary surgical interventions and surgery. Although most cases are selflimiting, RSH can lead to significant morbidity and its overall mortality rate is reported as 4%. Materials and methods: Patients diagnosed with RSH from August 2007 to December 2013 were retrospectively searched in double centre. The demographic data, possible causes of RSH as comorbid conditions or predisposing medications and imaging findings, therapeutic interventions, complications and outcomes of 24 patients were analysed. Results: 32 patients were identified in the present study. Eight cases were excluded due to other diagnosis, as post traumatic or postsurgical RSH. There were 8 males (33.3%) and 16 females (66.7%), with an age range of 24 to 86 years. The majority of the patients (79.1%) were treated by such conservative methods, while 5 (20.8%) patients underwent surgery, and has been performed percutaneous drainage for RSH abscess. Discussion: With increased use of anticoagulant and thrombolytic therapies, RSH are becoming more prevalent. Majority of the patients could be treated by conservative methods. If the conservative management fails to control active bleeding and the patients become hemodynamically instable, surgery should be the next step. RSH is commonly misdiagnosed as acute intra-abdominal event, and an high index of suspicion is required in patients with acute abdomen, in presence of a palpable abdominal mass and anemia.