Bilateral rectus sheath haematomas

Case contributed by Dr Ian Bickle

Presentation

Older male patient on medical ward. Diffuse abdominal pain. Perforation?

Patient Data

Age: 70 years
Gender: Male

Bilateral 5cm rectus sheath haematomas with haemorrhagic fluid levels within. Gallstones. Marked faecal loading in the right side of the colon.  No obstruction.  No mass. No free fluid or gas. Atrophic pancreas.

Case Discussion

Bilateral rectus sheath haematomas - spontaneous ones are typically secondary to warfarin therapy.

No history of warfarin therapy given at the time of the request - subsequent investigation into the clinical notes revealed patient on warfarin therapy with an elevated INR.

It is less common to observed fluid levels within the rectus sheath haematomas.

 

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Case information

rID: 50778
Case created: 21st Jan 2017
Last edited: 3rd Jul 2017
Inclusion in quiz mode: Included

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