Rectus sheath haematoma

Rectus sheath haematomas, as the term implies, occur when a haematoma forms in the rectus abdominis muscle / rectus sheath. It is most common in its lower segment and is generally self-limiting.

Rectus sheath haematomas are more common in women with a 3:1 F:M ratio.

Aetiology

Majority of haematomas result from the rupture of epigastric vessels or by tearing of the fibres of the rectus abdominis muscle. This can be due to 1, 4:

  • spontaneously in the context of anticoagulation therapy (most common)
  • direct or indirect trauma
  • coagulopathies
  • degenerative vascular diseases
  • iatrogenic, e.g. from high femoral arterial puncture
Ultrasound
  • heterogeneity in rectus abdominis muscle
CT
  • haematoma is confined to the abdominal wall.
  • high attenuation on unenhanced images
  • lack of enhancement
  • resolution on follow-up studies help confirm the diagnosis
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Article Information

rID: 10574
Section: Pathology
Synonyms or Alternate Spellings:
  • Rectus sheath hematoma
  • Rectus sheath haematoma (RSH)
  • Rectus sheath hematomas
  • Rectus sheath haematomas

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    Case 1: spontaneous
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    Case 2
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    Rectus Sheath Hae...
    Case 3
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    Case 4
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    Iatrogenic rectus...
    Case 5: from high femoral artery puncture
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    Case 6
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    Case 7: postoperative, on ultrasound
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