Rectus sheath hematoma

Case contributed by Dr Vitalii Rogalskyi


Acute right lower quadrant pain, vomiting. Palpable solid lesion in this area.

Patient Data

Age: 65 years
Gender: Female

CT abdomen

CT of the abdomen demonstrates lobulated hyperdense structure within the sheath of right rectus abdominis muscle with no obvious enhancement.  

Other organs are unremarkable.

Also, there is a prosthetic mitral valve.

Annotated image

Annotated images

Mitral valve prosthesis (red arrow). Rectus sheath non-enhanced mass (yellow arrows).

Case Discussion

This patient has anamnesis of mitral valve replacement and she takes warfarin (anticoagulant) as life-long supportive therapy. But last 2 months she didn't check INR (International normalized ratio - lab test that times the clotting of blood, ideally it should be performed every 4 weeks ).

So, this rectus sheath mass is hematoma as a complication of warfarin therapy. 

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Case information

rID: 66220
Published: 12th Feb 2019
Last edited: 14th Feb 2019
Inclusion in quiz mode: Included

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