Rectus sheath hematoma

Case contributed by Bahman Rasuli
Diagnosis almost certain


Sudden onset lower abdominal pain and hypotension.

Patient Data

Age: 50 years
Gender: Female

Expanded with heterogeneous hematoma is present at the rectus sheath in the left side.

Similar heterogenous hematoma also is seen within the pelvic cavity with pressure effect on the left adnexa and bladder wall in the left side. 

There is no retroperitoneal hemorrhage. 

Three small hypodense lesions are seen within the spleen parenchyma.

Three diverticula are seen at the second and third segments of duodenum without inflammation.

atherosclerotic plaques are seen along the course of the abdominal aorta and its branches.

Sliding hiatal hernia is seen.

Degenerative changes as endplates sclerosis and marginal osteophyte formation are seen along with thoracolumbar spine.

Mitral valvoplasty also is noted.

Case Discussion

The recent case with the history of anticoagulant treatment for three years referred to us with sudden onset lower abdominal pain and orthostatic hypotension. CT demonstrated a moderate sized left sided rectus sheath and intrapelvic spontaneous hematoma.

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