How painful is a rectus sheath hematoma?
The typical presentation of a rectus sheath hematoma is abdominal pain and its associated symptoms like nausea and vomiting. The pain is often sudden in onset, sharp, and does not radiate. In extremely rare cases, the hematoma may be large and present with hypovolemia, tachycardia, and tachypnea.
How long does an abdominal hematoma last?
Mild hematomas and contusions typically heal within about five days. A large hematoma may last weeks to months and as it heals it will change color and slowly shrink in size. Hematoma pain and swelling may be treated with over-the-counter (OTC) pain medications. Aspirin should not be used as it may increase bleeding.
What is a hematoma of rectus sheath?
Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma.
Are hematomas painful?
Many hematomas are simple. A hematoma under the nail or skin may be painful, but it will not usually cause complications. If a hematoma is especially painful, it is best to seek medical attention. A doctor can provide tips on wrapping or bracing the area.
What causes a hematoma in the abdomen?
Abdominal wall hematomas are an uncommon cause of acute abdominal pain and are often misdiagnosed. They result from rupture of the epigastric vessels or the deep circumflex iliac artery (rarely), or from tears of the fibers of the rectus abdominis or lateral oblique muscles [1,2].
What causes a rectus sheath hematoma?
What kind of disease is rectus sheath hematoma?
Rectus sheath hematoma (RSH) is a rare clinical entity. It can be mistaken for other intra-abdominal disorders, which can result in diagnostic and therapeutic difficulties. This study was undertaken to analyze the clinical presentation, diagnostic modalities, and management of patients affected with RSH.
How long does it take for rectus sheath hematoma to heal?
Computed tomography scan shows the hematoma limited in the right rectus abdominal muscle. The mean hospital stay was 6 days (range, 3–15 days). There were no mortality or thromboembolic complications. The elevated INR returned to normal within 4 days of cessation of anticoagulant therapy.
When to restart anticoagulation after Spontaneous rectus sheath hematomas?
In those with resumption of anticoagulation, the majority of patients were safely restarted by day 4. Even though complications secondary to anticoagulation were few, thrombotic complications outnumbered bleeding complications, suggesting that anticoagulation was withheld for too long after RSH diagnosis.
Where does the posterior rectus sheath protect the umbilicus?
This sheath protects the superior epigastric artery (terminal branch of the internal mammary artery) and the inferior epigastric artery (branch of the external iliac artery). Below this line, approximately 5 cm under the umbilicus, the posterior rectus sheath is absent.