Rectus sheath hematoma: a series of unfortunate events

World J Surg. 2006 Nov;30(11):2050-5. doi: 10.1007/s00268-005-0702-9.


Introduction: Rectus sheath hematoma is rare. It can present to physicians in many specialties, but invariably the surgeon is contacted regarding management. It is frequently difficult to diagnose, which can result in delay of treatment or unnecessary surgery. Its incidence is on the rise.

Methods: We present a series of four cases of rectus sheath hematoma that presented to our hospital within a 5-month period. A comprehensive up-to-date review of the literature was undertaken.

Results: Our research highlights the diagnostic dilemmas, the spectrum of severity (all three grades are represented), the complications, and the need for interdisciplinary awareness.

Conclusions: Rectus sheath hematoma is a rare but important entity in the differential diagnosis of abdominal pain. Interdisciplinary awareness of this condition is essential, as it is frequently difficult to diagnose, leading to delay in treatment or unneeded surgery. Grade 3 hematomas can lead to abdominal compartment syndrome and can be fatal.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Wall*
  • Aged
  • Female
  • Hematoma* / diagnostic imaging
  • Hematoma* / therapy
  • Humans
  • Middle Aged
  • Radiography