Rectus abdominis hematoma following cesarean section

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

A right lower abdominal mass. Had cesarean section 10 days ago.

Patient Data

Age: 40 years
Gender: Female

There is a well-defined mass in the abdominopelvic wall of right paramedian location centered on the rectus abdominis muscle. It is spontaneously hyperdense with no enhancement on postcontrast sequence, protruding into the abdominal cavity, displacing the adjacents digestive structures as well as the uterus to the left. 

With a 6 MHz probe, there is a complex heterogeneous hypoechoic mass, displacing the uterus to the left. The use of a high-frequency probe (12 MHz in this case) confirms that the mass is originating from the abdominal wall.

Case Discussion

CT and ultrasound features of an abdominal wall hematoma centered on the right rectus abdominis muscle protruding into the abdominal cavity mimicking a laterouterine mass on abdominal ultrasound.

The exploration of a superficial mass with a low-frequency probe can be misleading concerning the origin of the mass.  In such a case, the use of a high-frequency probe resolves this dilemma.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.