Spontaneous rectus sheath hematoma: ED diagnosis and management

Rare Cause of Cough-Induced Abdominal Pain

Rectus sheath hematoma is a rare cause of acute abdomen, and its clinical diagnosis is challenging without any imaging methods. We describe a case of a 50-year-old woman with no significant medical history who developed a sudden abdominal pain following a cough paroxysm. On physical examination, there was intense pain after light percussion and tenderness on palpation. Laboratory findings were within normal range. The imaging findings allowed us to diagnose a spontaneous rectus sheath hematoma. A conservative approach was opted. The patient had a favorable course. Accurate diagnosis is of the utmost importance as it may avoid unnecessary interventions, and in some cases, especially for elderly people, it can be fatal. This case alerts us to a rare cause of acute abdomen.

A case of rectus sheath hematoma caused by yoga exercise

Rectus sheath hematoma is a relatively rare condition but a significant cause of acute abdominal pain. The acute abdominal pain associated with rectus sheath hematoma can mimic several conditions, such as appendicitis, intestinal problems (obstruction, perforation, hernia, malignancy), and gynecologic disease (ovarian cyst, torsion, tubo-ovarian abscess, ectopic pregnancy). Correct diagnosis and subsequent treatment depends on careful history taking and appropriate use of diagnostic tools to avoid unnecessary laparotomy. We report a case of rectus sheath hematoma due to noncontact strenuous exercise, yoga, that mimicked gynecologic diseases.

Rectus sheath hematoma

We describe 3 patients with rectus sheath hematoma presenting to the emergency department. Prompt consideration of this uncommon cause of abdominal pain may prevent more expensive and invasive diagnostic tests and, in some cases, unnecessary hospitalization and laparotomy.

Spiral CT and three-dimensional CT of musculoskeletal pathology. Emergency room applications

Spiral CT is a fast and effective modality for evaluating a wide variety of musculoskeletal abnormalities in the emergency department setting. The role of spiral CT in evaluating musculoskeletal trauma and musculoskeletal inflammation and infections is discussed, as is the use of multiplanar and three-dimensional imaging.

CT of hemorrhagic complications of anticoagulant therapy

Anticoagulant therapy is commonly used in patients at risk for, or known to have, thromboembolic disease. Although complications of therapy are uncommon in most patients, in others it may result in complications with substantial morbidity and occasionally may be life threatening. This essay reviews the role of anticoagulant therapy and defines the potential complications that may occur in the chest, abdomen, musculoskeletal system, and CNS. Specific pitfalls in diagnosis as well as complications of the bleeding process are discussed and illustrated. The role of CT scanning in the diagnosis and triage of these patients is clearly defined through select cases and clinical dilemmas.