Diagnosis of Rectus Sheath Hematoma by Point-of-Care Ultrasound

2019 ◽  
Vol 56 (6) ◽  
pp. 680-683 ◽  
Author(s):  
Casey Carr ◽  
Randall Rhyne
POCUS Journal ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 8-9
Author(s):  
Jeffrey Lam ◽  
Steven Montague

A 78-year-old male with chronic kidney disease on peritoneal dialysis developed unprovoked bilateral pulmonary embolisms. He was started on IV unfractionated heparin, but shortly thereafter developed severe pain and a small firm abdominal nodule near his dialysis catheter site. The diagnosis was unknown, and the initial plan was watchful waiting, until point-of-care ultrasound (POCUS) was used. POCUS revealed an ovoid mass with hyperdensity in the gravity dependent regions with spontaneous movement. This appearance was classic for the hematocrit sign. When combined with the clinical presentation, this was concerning for a rectus sheath hematoma. An urgent CT of the abdomen confirmed this several hours later. POCUS allowed for rapid bedside diagnosis, which expedited appropriate care in a potentially life-threatening situation.


CJEM ◽  
2013 ◽  
Vol 15 (02) ◽  
pp. 120-123 ◽  
Author(s):  
Hamid Shokoohi ◽  
Keith Boniface ◽  
M. Reza Taheri ◽  
Ali Pourmand

ABSTRACTSpontaneous rectus sheath hematoma is an uncommon condition that can mimic other conditions associated with an acute abdomen. We report the case of a patient with a spontaneous rectus sheath hematoma due to a ruptured inferior epigastric artery pseudoaneurysm who presented with hypotension and severe abdominal pain and was diagnosed using emergency department point-of-care ultrasonography. Point-of-care ultrasonography has been increasingly used in the evaluation of emergency department patients with acute abdomen and hypotension to expedite the diagnosis and management of aortic aneurysm and intraperitoneal bleeding. Resuscitation and urgent surgical and interventional radiology consultations resulted in the successful embolization of a branch of the inferior epigastric artery and a good outcome.


POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.


POCUS Journal ◽  
2017 ◽  
Vol 2 (2) ◽  
pp. 15-17
Author(s):  
Rimi Sambi, MD ◽  
Heather Sawula, MD ◽  
Brent Wolfrom, MD ◽  
Joseph Newbigging, MD

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing [1]. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University. Third year medical students (n=18) were recruited to participate in a training session involving a 1-hour online video and 2-hour hands-on session. Knowledge based surveys were completed before and after the training. A survey was completed 4 months after the teaching session evaluating knowledge retention, comfort, and application of skills. Student knowledge of PoCUS and FAST increased and was maintained (pre-training 56%±20%, post-training 82%±10%, p<0.001). Self-evaluation of comfort performing a FAST examination (5-point Likert scale) similarly increased post-training session (pre-training 1.4±0.8, post-training 3.8±0.9, p<0.005), but decreased 4 months later (3±1.2, p<0.005). Students in this study were unanimously interested in ultrasound training and the methods used effectively increased theoretical knowledge and comfort with use. Students did not retain their comfort levels with FAST exam 4 months after the training session, nor did they have the opportunity to utilize the skills learned. Further evidence is required to identify the applicability of these results to undergraduate curriculum development.


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