Document Detail

Spontaneous rectus sheath hematoma pregnancy: case report and review of the literature.
MedLine Citation:
PMID:  20955630     Owner:  NLM     Status:  In-Process    
Rectus sheath hematoma (RSH) is a rare, but important potential cause of acute upper abdominal pain in pregnancy. We report a patient with history of hemolysis, elevated liver enzymes, low platelets syndrome who presented with upper abdominal pain, hypotension, elevated hepatic transaminase levels, and a visibly enlarging right costal margin mass at 33 weeks' gestation. She underwent emergent cesarean delivery and upper abdominal exploration with findings of a large hematoma involving the entire right rectus sheath. The current case illustrates that the diagnosis of an RSH in pregnancy can be difficult as its presentation can mimic many common causes of abdominal pain seen outside of pregnancy, as well as many specific to pregnancy. Review of the published cases from the past 20 years shows that correct diagnosis remains difficult in pregnancy despite advances in diagnostic imaging. Although management of an RSH outside of pregnancy is frequently conservative, it is very often treated surgically in pregnant patients and often leads to preterm delivery.
Mary C Tolcher; Joshua F Nitsche; Katherine W Arendt; Carl H Rose
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrical & gynecological survey     Volume:  65     ISSN:  1533-9866     ISO Abbreviation:  Obstet Gynecol Surv     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401007     Medline TA:  Obstet Gynecol Surv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  517-22     Citation Subset:  IM    
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN 55905, USA.
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