Surgical Management of A Rectus Sheath Hematoma Perforating the Bladder Wall: Multidisciplinary Approach & Literature Review

Depalma N, Toccaceli S and La Torre F

Department of Emergency Surgery, Policlinico Umberto I, Italy

^*Correspondance to: Stefano Toccaceli 

 PDF  Full Text DOI: 10.25107/2474-1647.1497

Abstract

The Rectus Sheath Hematoma (RSH) accounts only for less than 2% of patients presenting with acute abdominal pain. In the majority of cases it’s due to a spontaneous self-limiting bleeding from the inferior epigastric artery (IEA) and the treatment is conservative. We present the case of a 71 year-old woman assuming warfarin for persistent atrial fibrillation that underwent an intervention for pacemacker RCT-D positioning, who developed a large RSH invading the pelvis and eroding into the bladder wall, causing gross haematuria. This case reports highlights the uniqueness of this particular presentation and the necessity of an emergency surgical management based on the patient haemodynamic instability and hematoma characteristics.

Keywords

Rectus sheath hematoma; Bladder perforation; Hypovolemic shock

Cite the article

Depalma N, Toccaceli S, La Torre F. Surgical Management of A Rectus Sheath Hematoma Perforating the Bladder Wall: Multidisciplinary Approach & Literature Review. Clin Surg. 2017; 2: 1497.