Spontaneous hematoma of the rectus abdominal wall in pregnancy

AbstractRectus sheath hematoma is an uncommon and often clinically misdiagnosed cause of abdominal pain. We report such a case of a 42-year-old woman who developed an abdominal-wall hematoma at 32 weeks of gestation. Initially, she was suspected as having a complicated ovarian tumor associated with pregnancy, because of the intense abdominal pain. Both ultrasound and magnetic resonance imaging proved to be useful in diagnosing rectus sheath hematoma. A conservative management was applied for the rectus sheath hematoma and the patient recovered uneventfully. Although it is a very rare entity, rectus sheath hematoma should be included in the differential diagnosis of every pregnant patient who presents with abdominal pain.

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The Pregnant Surgical Patient

10.2310/surg.2177 ◽

2015 ◽

Author(s):

Nina Tamirisa ◽

Sami Kilic ◽

Mostafa Borahay

Keyword(s):

Critical Care ◽

Abdominal Pain ◽

Imaging Modality ◽

Pregnant Patient ◽

Surgical Patient ◽

Changes In Pregnancy ◽

Surgical Conditions ◽

Laboratory Changes ◽

In Pregnancy

The most vulnerable time for a fetus is during embryogenesis in the first 8 to 10 weeks of pregnancy, when women may be unaware of their pregnancy. Once pregnancy is established, a standard approach to the pregnant patient is the optimal way to ensure medical and surgical decisions are made within the context of maintaining the safety of both mother and fetus. This review describes the approach to the pregnant patient for surgical conditions within the context of physiologic changes of the patient and fetus at each trimester, anesthesia and critical care in pregnancy, imaging and drugs safe for use in pregnancy, and nongynecologic surgery in the pregnant patient and specific surgical conditions. Tables outline the classification of abortion, the assessment of pregnancy viability, physiologic changes in pregnancy, laboratory changes in pregnancy, imaging modality and radiation dose, and antibiotics and safety in pregnancy. Figures include a diagram of types of hysterectomy, respiratory changes in pregnancy, and enlargement of the uterus. Algorithms outline the approach to abdominal pain in the pregnant patient and diagnosis and management of ectopic pregnancy. This review contains 5 figures, 6 tables, and 85 references.

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Spontaneous hematoma of the breast: What can we learn about the management of blunt force trauma of the female breast and spontaneous rectus sheath hematoma?

The Breast Journal ◽

10.1111/tbj.13755 ◽

2020 ◽

Vol 26 (7) ◽

pp. 1431-1433

Author(s):

Louise Alder ◽

Alexandra Kenchington ◽

Avi Agrawal

Keyword(s):

Rectus Sheath ◽

Blunt Force ◽

Blunt Force Trauma ◽

Female Breast ◽

Rectus Sheath Hematoma ◽

Spontaneous Hematoma

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Rectus sheath hematoma in pregnancy

Journal of Clinical Ultrasound ◽

10.1002/jcu.1040 ◽

2001 ◽

Vol 29 (5) ◽

pp. 306-311 ◽

Cited By ~ 30

Author(s):

Rachel Humphrey ◽

S. J. Carlan ◽

Lennard Greenbaum

Keyword(s):

Rectus Sheath ◽

Rectus Sheath Hematoma ◽

In Pregnancy

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Mushroom cloud appearance of hemorrhage into the superficial anterior abdominal wall associated with an underlying rectus sheath hematoma

Clinical Anatomy ◽

10.1002/ca.20069 ◽

2005 ◽

Vol 18 (2) ◽

pp. 141-145

Author(s):

Nadim Gulamhuseinwala ◽

Philippa Webb

Keyword(s):

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Rectus Sheath ◽

Rectus Sheath Hematoma

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Acute gangrenous appendicitis and acute gangrenous cholecystitis in a pregnant patient, a difficult diagnosis: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20211831 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1575

Author(s):

David Lew ◽

Jane Tian ◽

Martine A. Louis ◽

Darshak Shah

Keyword(s):

Abdominal Pain ◽

Case Report ◽

General Population ◽

Acute Appendicitis ◽

Acute Cholecystitis ◽

Pregnant Patient ◽

Anatomical Changes ◽

Difficult Diagnosis ◽

Common Complaint ◽

In Pregnancy

Abdominal pain is a common complaint in pregnancy, especially given the physiological and anatomical changes that occur as the pregnancy progresses. The diagnosis and treatment of common surgical pathologies can therefore be difficult and limited by the special considerations for the fetus. While uncommon in the general population, concurrent or subsequent disease processes should be considered in the pregnant patient. We present the case of a 36 year old, 13 weeks pregnant female who presented with both acute appendicitis and acute cholecystitis.

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Management of ureteric stones in pregnancy

10.1093/med/9780199659579.003.0029 ◽

2017 ◽

Author(s):

Ben Turney ◽

John Reynard

Keyword(s):

Abdominal Pain ◽

Renal Colic ◽

Treatment Options ◽

Pregnant Patient ◽

Stone Extraction ◽

Surgical Technology ◽

Recommended Treatment ◽

Potential Problems ◽

Primary Management ◽

In Pregnancy

Renal colic is the most common non-obstetric cause for abdominal pain and hospitalization during pregnancy. Ureteric stones occur in about 1 in 2,000 pregnancies, most (>80%) in the second and third trimesters. Primary management concerns are diagnostic foetal radiation exposure and the potential for adverse perinatal events arising either from the stone or from intervention. Indications for intervention are the same as for the non-pregnant patient, but are influenced by obstetric circumstances. Active treatment options may be temporizing (stent or nephrostomy) or definitive (ureteroscopic stone extraction). Historically, temporizing measures were the only recommended treatment option. However, potential problems associated with temporary drainage mechanisms include recurrent obstruction, infection, nephrostomy displacement, encrustation, infection, and pain. These factors may impact on pregnancy. In recent years, advances in surgical technology and technique have permitted definitive ureteroscopic management of stones during pregnancy.

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