Rectus Sheath Hematoma Secondary to Domestic Violence

Elgun Samadov,Arturan Ibrahimli,Samir Mamishov

doi:10.7759/cureus.17058

Abstract

Rectus sheath hematoma (RSH) is an infrequent condition that occurs when epigastric arteries bleed into the rectus sheath and sometimes acts like an acute abdomen. In view of the fact that it is a rare case without specific clinic signs, misdiagnosis and use of invasive manipulations for patients are possible. A 27-year-old woman applied to our clinic with abdominal pain, weakness, and nausea. Acute abdominal pain was in the periumbilical region and physical examination revealed tenderness, rebound phenomenon, and local mass in the right periumbilical region. Rectus sheath hematoma was identified by magnetic resonance imaging. The cause in this case was abdominal trauma due to domestic violence. After the legal procedures, symptomatic treatment was prescribed to the patient. Interestingly in this case, we did not get to the diagnosis through history, we reached the history after diagnosis. Besides the treatment of the patient, maybe our team prevented further violence against a woman.

Highlights

Rectus sheath hematoma (RSH) is an infrequent condition that occurs when epigastric arteries bleed into the rectus sheath and sometimes acts like an acute abdomen
After magnetic resonance imaging and computer tomography findings revealed rectus sheath hematoma, we could talk with the patient privately and we understood that the patient faced violence in the family several days before the symptoms occurred
Rectus sheath hematoma is a rare outcome of abdominal traumas

Summary

Introduction

Rectus sheath hematoma (RSH) is an infrequent condition that occurs when epigastric arteries bleed into the rectus sheath and sometimes acts like an acute abdomen. Rectus sheath hematoma emerges from many reasons, such as anticoagulant therapies, severe exercise, and trauma. Abdominal trauma caused by violence against women is often skipped by many doctors because of the incorrect history of the patient. In this case, the significance of rectus sheath hematoma diagnosis in abdominal pain and the doctor’s role in preventing domestic violence are mentioned. The patient underwent abdominal ultrasonography, which confirmed a large complex, avascular, heteroechoic mass along the lower rectus sheath. After magnetic resonance imaging and computer tomography findings revealed rectus sheath hematoma, we could talk with the patient privately and we understood that the patient faced violence in the family several days before the symptoms occurred. At two weeks’ control check, improvement in symptoms was examined and the hematoma had contracted according to ultrasound imaging results

Discussion

Conclusions

Findings

Disclosures

McKim LH