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Vascular Medicine
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case-report

Rectus sheath hematoma

Olusegun Osinbowale

Section of Vascular Medicine, Department of Cardiology Ochsner Clinic Foundation, New Orleans, USA oosinbowale{at}ochsner.org

John R Bartholomew

Section of Vascular Medicine, Department of Cardiology Ochsner Clinic Foundation, New Orleans, USA; Department of Hematology & Medical Oncology, Cleveland Clinic Foundation, Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA

Abstract

Rectus sheath hematoma (RSH) is a known complication of anticoagulation therapy and a source of potential morbidity and mortality. Early diagnosis and appropriate treatment may help to prevent complications including hemodynamic instability, the abdominal compartment syndrome or multiorgan dysfunction. Although the diagnosis can be made clinically, it can be confirmed with computed tomography of the abdomen. Most patients can be managed conservatively; however, it is often necessary to suspend anticoagulation in the acute setting. Rectus sheath hematoma is not a contraindication to resuming anticoagulation once the hematoma has been adequately managed and the patient has returned to a stable clinical baseline.

Key Words: abdominal compartment syndrome • abdominal pain • anticoagulation • rectus sheath hematoma

Vascular Medicine, Vol. 13, No. 4, 275-279 (2008)
DOI: 10.1177/1358863X08094767
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