Bilateral rectus sheath hematomas

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 hematomas with hemorrhagic fluid levels within. Gallstones. Marked fecal loading in the right side of the colon.  No obstruction.  No mass. No free fluid or gas. Atrophic pancreas.

Case Discussion

Bilateral rectus sheath hematomas - 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 hematomas.

 

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Case information

rID: 50778
Published: 4th Feb 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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