Acute abdomen secondary to dependent rectus sheath hematoma: a case report

Juan José Granados-Romero, Carlos Aarón Méndez-Celis, Ericka Hazzel Contreras-Flores, Jesús Carlos Ceballos-Villalva, Aranza Guadalupe Estrada-Mata, Luis Eugenio Graniel-Palafox, José Javier Romo-García, Mariana Espejel- Deloiza, Germán Eduardo Mendoza-Barrera, Alan Isaac Valderrama-Treviño


The rectus sheath hematoma as a rare clinical entity and self-limited, resulting from the accumulation of blood within the sheath of the rectus abdominis, secondary to breakage the epigastric artery higher or lower, or direct damage by fiber tear of rectus abdominis muscle. Female patient, 37 years old, enters the service of emergencies by refer abdominal pain of sudden onset, diffuse, with 5 hours of evolution with irradiation to lumbar region ipsilateral. In the CT scan in single stage and with IV contrast, it was reported an asymmetry in the thickness of the muscles of the anterior wall at the expense of a lesion of occupying space dependent anterior rectus muscle, as diagnostic impression is concluded a intramuscular injury dependent of the right anterior abdominal straight; likely bruising of the sheath of the straight abdominal by what is being decided its income to operating room to perform surgical drainage and epigastric vessel ligation. for the general doctor, specialist and it is important to take into account the pathology, symptoms, diagnostic and therapeutic strategy for a hematoma dependent of the rectus abdominis muscle, due to the high percentage of error diagnosis in patients who are admitted to the emergency department with acute abdominal pain, because you can Confused with other abdominal pathologies, which shows the importance of an appropriate differential diagnosis, and treatment prescribed, which optimize and reduce unnecessary intervention as well as morbidity and mortality of this disease.


Acute abdomen, Hematoma of the rectus abdominis, Hematoma of the rectus sheath

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