Rectus Sheath Hematoma, a Rare Complication of Asthma: A Case Report

Abstract

Hematoma of the rectus sheath is a rare complication of asthma. We describe a case of rectus sheath hematoma caused by severe coughing during an exacerbation of asthma. This 65-year-old male patient had been a victim of asthma for more than 8 years. He suffered an acute attack of asthma and was treated at a local hospital five days before this admission. Two days later, a sudden onset of severe cough followed by abdominal pain occurred. The physical examination found an ecchymosis measuring 10x12 cm in size at the periumbilical area of the abdomen. Computed tomography of the abdomen revealed a well-defined soft tissue mass with contrast media enhancement in the left rectus sheath, consistent with rectus sheath hematoma. The aspirate from an ultrasound-guided diagnostic tapping also showed the blood clot. The patient received bronchodilators, corticosteroids, antitussive agents, and local heat packing for this abdominal wall lesion. The clinical condition of the patient improved gradually and he was discharged 2 weeks after admission. Failure to suspect the presence of a rectus sheath hematoma as a cause of acute abdominal pain may result in unnecessary invasive diagnostic studies or laparotomy.