Spontaneous rectus sheath hematoma associated with COVID-19 infection

Case contributed by Mahsa Taherzadeh


Left lower quadrant abdominal pain 3 days after hospitalizing due to COVID19 infection.

Patient Data

Age: 40 years
Gender: Female

There is a round hyperdense lesion in the left rectus sheath in non-contrast CT scan images. A focus of IV contrast extravasation and layering of contrast media in the dependent part of the lesion in the contrast-enhanced CT scan images is noted compatible with active bleeding.

Case Discussion

Rectus sheath hematoma could be spontaneous (as in this case) or due to trauma. It is more common in females. Recently there were some reports of rectus sheath hematoma in COVID-19 infection 1.

CT scan shows hyperdense lesion confined to the rectus sheath in non-contrast images with no enhancement in post-contrast images.

Contrast extravasation in the lesion in post-contrast images suggests active bleeding.

Resolution of the lesion in follow-up scans helps to confirm the diagnosis.

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