Rectus sheath hematomas (RSHs) are generally caused either by rupture of one of the epigastric arteries or by a muscular tear with shearing of a small vessel.
How long does a rectus sheath hematoma last?
The majority of patients recover well with no complications as the hematoma is reabsorbed in 2 to 3 months.  In those with an indication for therapeutic anticoagulation, patients should be counseled on the risk for recurrence with the resumption of therapy.
How is rectus sheath hematoma diagnosed?
The best diagnostic modality to evaluate a suspected RSH is an abdominal computerized tomography (CT) scan, which is more specific than ultrasonography. (Abdom Imaging 1996;21:62.) Sonographic findings are nonspecific in some cases, and can mimic abdominal wall tumors and inflammatory diseases.
How is rectus sheath hematoma treated?
Conservative treatment of rectus sheath hematoma includes rest; analgesics; hematoma compression; ice packs; treatment of predisposing conditions; and if necessary, more aggressive therapies of intravenous fluid resuscitation, reversal of anticoagulation, and transfusion.
Is the rectus sheath a ligament?
The rectus sheath is a tendon sheath (aponeurosis) which encloses the rectus abdominis and pyramidalis muscles. It is an extension of the tendons of the external abdominal oblique, internal abdominal oblique, and transversus abdominis muscles.
How do you treat rectus sheath hematoma?
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.
What is found in the rectus sheath?
The rectus sheath is the durable, resilient, fibrous compartment that contains both the rectus abdominis muscle and the pyramidalis muscle. The fascial coverings of the external oblique, internal oblique, and transversus abdominis muscles comprise the rectus sheath.
What does it feel like to tear an abdominal muscle?
A pulled abdominal muscle can make the abdomen feel sore and tender, especially during movement. If people have pulled a muscle, they may notice the following symptoms in and around the abdomen: soreness or tenderness. pain or discomfort when touching the abdomen.
What does an abdominal hematoma feel like?
On the other hand, an oblique muscle hematoma caused by a rupture of the deep circumflex iliac artery is very rare . The most common presenting signs and symptoms of these hematomas are acute abdominal pain and firm, palpable abdominal wall masses.
What happens if you tear the rectus abdominis?
Injuries to this muscle result in varying degrees of abdominal strain. Minor strains result in stretching of the rectus abdominis, while major strains result in complete ruptures or tears and may also trigger bleeding and the formation of an abdominal hernia.
What are the symptoms of a rectus sheath hematoma?
A low-grade fever is common in rectus sheath hematoma. The rectus sheath hematoma can be large enough to compromise intravascular volume, with resultant signs of hypovolemic shock including hypotension, tachycardia, and tachypnea.
Can a rectus sheath hematoma mimic a tumor?
Rectus sheath hematoma may mimic several more common conditions, such as intestinal obstruction, perforated peptic ulcer, pancreatitis, diverticulitis, tumors or a ruptured aortic aneurysm 3). Thus, a high index of suspicion and a careful diagnostic workup are mandatory to reach an accurate diagnosis, so as to focus on the correct treatment.
What causes a muscle strain in rectus abdominis?
Labor-related causes of a strain include sudden twisting motions or the lifting of heavy objects. Athletics-related causes include pole-vaulting, weightlifting, swimming the breaststroke, performing sit-ups and engaging in skating or hockey.