2021, Number 08
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Ginecol Obstet Mex 2021; 89 (08)
Rectus sheath hematoma as a complication of gynecologic surgery: case report and literature review
Casteleiro-Deus N, Pardo-Pumar MI, Vidal-Hernández R, Bobillo-Varela C, Moral-Santamarina JE
Language: Spanish
References: 11
Page: 655-661
PDF size: 249.77 Kb.
ABSTRACT
Background: Rectal sheath hematoma is an infrequent finding that, on multiple
occasions, is associated with predisposing factors, such as laparoscopic surgery.
Objectives: To define the etiology, possible predisposing factors and related triggers.
To approach the most frequent clinical manifestations, the most relevant diagnostic
tests and the most appropriate treatments.
Clinical case: 46-year-old patient, diagnosed with right adnexal cyst, proposed for
laparoscopic surgery. Two days postoperatively she presented with acute abdominal
pain accompanied by a drop in hemoglobin. Imaging tests showed a large hematoma
in the abdominal wall, in the rectus abdominis area, with active bleeding. Surgical
treatment allowed identification and ligation of the bleeding vessel and drainage of
the hematoma. During the postoperative period the patient evolved favorably and was
discharged asymptomatic.
Conclusions: Although rectus sheath hematoma is an exceptional clinical finding
that usually dissolves with conservative treatment, on some occasions the delay in
diagnosis can be life-threatening for the patient. It is a condition that should be kept in
mind when establishing the differential diagnosis of acute abdominal pain. This is how
an accurate and early diagnosis can be reached, and the most appropriate treatment
for each case can be indicated.
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