Document Detail

Rectus sheath hematoma caused by non-contact strenuous exercise mimicking acute appendicitis.
MedLine Citation:
PMID:  18722739     Owner:  NLM     Status:  MEDLINE    
A healthy 26-year-old man visited the Emergency Department due to right lower quadrant pain of 2 days' duration that developed after wakeboarding. There was no history of direct trauma to the abdomen. Physical examination revealed tenderness and rebound tenderness on the right lower quadrant area. There was no palpable abdominal mass. Computed tomography (CT) of the abdomen was undertaken to discern the causes of acute abdomen, including acute appendicitis. CT revealed a small-size rectus sheath hematoma beneath the lower end of the right rectus muscle. The patient was admitted for supportive care including pain control and was discharged with improvement after 5 days. Rectus sheath hematoma can be caused by not only a direct blow but also non-contact strenuous exercise, for example, wakeboarding in this case. Although the majority of rectus sheath hematomas are self-limiting, some can cause peritoneal irritation signs, mimicking acute abdomen, and eventually lead to unnecessary laparotomy without clinical suspicion and ancillary tests including CT scan and ultrasonography.
Je Hyeok Oh; Tae Han Kim; Sung Jae Cha; Seung Ho Kim
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-08-23
Journal Detail:
Title:  The Journal of emergency medicine     Volume:  39     ISSN:  0736-4679     ISO Abbreviation:  J Emerg Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-06     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8412174     Medline TA:  J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e117-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Department of Emergency Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea.
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MeSH Terms
Abdomen, Acute / diagnosis*,  etiology
Appendicitis / diagnosis
Athletic Injuries / diagnosis*
Diagnosis, Differential
Hematoma / diagnosis*,  etiology
Rectus Abdominis / injuries*
Tomography, X-Ray Computed

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