Endovascular management of the rectus muscle hematoma

Pieri, Stefano; Agresti, Paolo; Buquicchio, Grazia Loretta; Giampietro, Ilenia Di; Trinci, Margherita; Miele, Vittorio

doi:10.1007/s11547-015-0516-2

Cited by 17 publications

(9 citation statements)

References 25 publications

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“…However, in some rare cases, it may become a serious condition due to persistent bleeding. The most frequent cause of spontaneous RSH is anticoagulation therapy 5 ) .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rectus sheath hematoma associated with warfarin administration: a case report

et al. 2019

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Objectives: Rectus sheath hematoma (RSH) can result from bleeding into the rectus abdominis muscle or a direct muscular tear; nontraumatic spontaneous RSH is a rare condition. Here, we report a case of spontaneous RSH associated with warfarin administration for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH).Patient: An 87-year-old woman was referred to our hospital because of abdominal pain, nausea, and vomiting for 3 days. She was receiving warfarin for treating CTEPH. She had a bulging and hard lower abdomen with ecchymosis. Moreover, the bulging portion was highly tender, and a positive Carnett’s sign was also observed. She reported no history of abdominal trauma. Abdominal computed tomography (CT) scan revealed right RSH.Results: She was diagnosed with spontaneous RSH and admitted to our hospital. Warfarin was antagonized with an intravenous injection of vitamin K; hemostatic agents were intravenously administered. Gradually, her abdominal pain improved. She was finally discharged 12 days after the admission. Abdominal CT scan performed 17 days after the discharge revealed a reduction in the size of RSH.Conclusion: Despite not having a history of trauma, it is necessary to consider the possibility of RSH for patients receiving warfarin and complaining of abdominal pain.

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“…However, in some rare cases, it may become a serious condition due to persistent bleeding. The most frequent cause of spontaneous RSH is anticoagulation therapy 5 ) .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rectus sheath hematoma associated with warfarin administration: a case report

et al. 2019

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“…First, soft-tissue hematoma has a self-tamponade effect that limits the expansion into the muscular component. Therefore, active bleeding might not necessarily result in severe blood loss (22). Second, the bleeding point is a distal branch of micro-vessels in the case of CRSH.…”

Section: Discussionmentioning

confidence: 99%

Coagulopathy-related soft tissue hematoma: a comparison between computed tomography findings and clinical severity

Nakayama

Kato

Yoshioka

et al. 2020

Acta Radiologica Open

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Background Despite increases in the incidence of coagulopathy-related soft-tissue hematoma (CRSH), the relationship between computed tomography (CT) features and clinical severity remains unclear. Purpose To retrospectively evaluate the correlation between CT findings and clinical outcomes in CRSH. Material and Methods We retrospectively reviewed data of patients diagnosed with CRSH between March 2011 and March 2018. CRSH was morphologically classified according to the presence or absence of the fluid level pattern and was also divided into groups with or without extravasation as per CT findings. These CT findings were compared with the patients’ vital signs and laboratory investigation results. Results A total of 47 patients with CRSH were examined. Fluid level and non-fluid level patterns were observed in 28 (60%) and 19 (40%) patients, respectively. Anticoagulant therapy and extravasation were significantly correlated with the fluid level pattern. However, other clinicolaboratory outcomes, including shock index, hemoglobin, hematocrit, platelet count, and coagulation factors, showed no significant difference between the two patterns. In the comparison of hematomas with and without extravasation, none of the clinicolaboratory outcomes except for anticoagulant therapy showed significant differences. Conclusion CRSH with a fluid level pattern is significantly associated with extravasation. However, extravasation, which is generally suggestive of active bleeding, does not seem to be related to clinical severity in CRSH.

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“…Selective arteriography instead is the most useful image technique to identify the presence and location of the bleeding; it provides information on the involved artery branches that support the bleeding and its exact location [2]. …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, despite correct medical treatment, some patients with continuous and/or consistent bleeding, presenting a large hematoma with a consistent hypovolemia, request a more radical handling. Percutaneous management by selective catheters and embolization of the bleeding vessel is considered the gold standard for nonmedical therapy [2]. …”

Section: Introductionmentioning

confidence: 99%

Spontaneous Hematoma of the Rectus Sheath: Urgent Embolization with Squidperi Liquid Embolic Device

Torcia

Rossi

Squarza

et al. 2017

Case Reports in Radiology

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Endovascular management of the rectus muscle hematoma

Cited by 17 publications

References 25 publications

Spontaneous rectus sheath hematoma associated with warfarin administration: a case report

Spontaneous rectus sheath hematoma associated with warfarin administration: a case report

Coagulopathy-related soft tissue hematoma: a comparison between computed tomography findings and clinical severity

Spontaneous Hematoma of the Rectus Sheath: Urgent Embolization with Squidperi Liquid Embolic Device

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