Document Detail

Expanding refractory rectus sheath hematoma: a therapeutic dilemma.
MedLine Citation:
PMID:  21647856     Owner:  NLM     Status:  Publisher    
PRectus sheath hematoma is an uncommon but well-described complication of a tussive paroxysm. It is an accumulation of blood within the sheath of the rectus abdominis secondary to disruption of the epigastric vessels or the rectus muscle and is often misdiagnosed as acute abdomen. Increases in the number of elderly patients and the use of therapeutic anticoagulation may increase the prevalence and severity of rectus sheath hematomas encountered in clinical practice. Expanding rectus sheath hematomas are occasionally refractory to conservative treatment and may require hemostatic intervention. Here, we describe the case of an 87-year-old woman who presented with two separate rectus sheath hematomas that were precipitated by a paroxysm of coughing. Repeated computed tomography showed two separate expanding rectus sheath hematomas, which were not accompanied by obvious contrast extravasation on angiography. Empiric left inferior epigastric artery embolization resulted in rapid hemodynamic stabilization, and the hematomas shrank gradually. Early empiric transcatheter arterial embolization may be appropriate for patients who are poor surgical candidates and have enlarging hematomas that are refractory to conservative treatment.
Guo-Shiang Tseng; Guo-Shiou Liau; Hann-Yeh Shyu; Shi-Jye Chu; Fu-Chang Ko; Kuo-An Wu
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-06
Journal Detail:
Title:  Diagnostic and interventional radiology (Ankara, Turkey)     Volume:  -     ISSN:  1305-3612     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101241152     Medline TA:  Diagn Interv Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan County, Taiwan, Republic of China.
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