Abdominal Compartment Syndrome as a Consequence of Rectus Sheath Hematoma

Abstract

Abdominal compartment syndrome is a well-documented entity arising from multiple and various causes. The rise of intra-abdominal pressure by the increase in volume of the peritoneal and retroperitoneal contents has been shown in the resuscitation and evaluation of surgical patients. However, the incidence of constriction of the abdomen causing intra-abdominal hypertension is unknown. Previously limited to burn eschar and externally applied devices (such as MAST trousers), external compression leading to abdominal compartment syndrome has been a limited entity. We report the first documented case of an expansive abdominal wall mass, a rectus sheath hematoma, leading to impending abdominal compartment syndrome.

Rectus Sheath Hematoma: A Series of Unfortunate Events

“…Complications of RSH include unnecessary surgery3 hypovolemic shock,21 muscle necrosis,22 medical complications such as myocardial infarction, and death 23. One of the more recently recognized complications is the abdominal compartment syndrome, which was first described by O’Mara et al 24. in 2003.…”

“…described by O'Mara et al 24 in 2003. We believe that our third patient suffered from abdominal compartment syndrome.…”