Rectus muscle sheath haematoma in a patient with congenital FX deficiency and in another with congenital FVII deficiency

Girolami, Antonio; Allemand, Emanuele; Tezza, Fabiana; Pellati, Donatella; Scandellari, Raffaella

doi:10.1111/j.1365-2516.2009.02091.x

Cited by 8 publications

(4 citation statements)

References 7 publications

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“…A rare hemorrhagic manifestation is represented by rectus muscle sheath hematomas (RMSHs). 13 This may occur spontaneously or after a trauma, even a mild one. If promptly diagnosed and treated, the condition evolves well.…”

Section: Resultsmentioning

confidence: 99%

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Rare and Unusual Bleeding Manifestations in Congenital Bleeding Disorders

Girolami

Vettore

Ruzzon

et al. 2011

Clin Appl Thromb Hemost

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Epistaxis, superficial and deep hematomas, hemarthrosis, gastrointestinal bleeding, hematuria represent the most frequent hemorrhagic events in congenital coagulation disorders. Occasionally, bleeding manifestations occur in unusual sites or are peculiar. A clotting defect may alter the clinical aspect of skin conditions or infections (hemorrhagic scabies or varicella). Hemobilia may occur as a complication of transjugular liver biopsy in hemophilia or Bernard-Soulier syndrome. Hemarthrosis of small joints of feet and hands occur in patients with hemophilia treated with protease inhibitors. Intramedullary hematomas of long bones have been described in α2-plasmin inhibitor or fibrinogen deficiencies. Spleen fracture with consequent hemoperitoneum has been reported in patients with fibrinogen deficiency. Rectus muscle sheath hematoma may occur in patients with factor VII (FVII)or FX deficiency. Acute or subacute intestinal obstruction may be caused by intramural wall hematomas in hemophilia and von Willebrand (vW)-disease. Physicians should always keep in mind that a congenital hemorrhagic disorder may cause bleeding in any tissue of the body and therefore alter the normal clinical features of a given disease.

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Section: Resultsmentioning

confidence: 99%

“…46,47 Similarly for what seen for FVII deficiency, at least a case of RMS hematoma has been described. 13…”

Section: Resultsmentioning

confidence: 99%

Rare and Unusual Bleeding Manifestations in Congenital Bleeding Disorders

Girolami

Vettore

Ruzzon

et al. 2011

Clin Appl Thromb Hemost

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“…Pregnancy, hypertension, previous abdominal surgery, coagulopathies or anti-platelet therapy have also been defined as risk factors. 1,[4][5][6] Incidence of spontaneous rectus sheath hematoma (SRHS) increases upon increased administration of antiplatelet and anticoagulant therapies, and the estimated annual rate of SRSH is 1.2% to 1.5%. 7 Early diagnosis and treatment are necessary in SRSH to minimize complications such as hemodynamic instability, abdominal compartment syndrome, multiple organ dysfunction syndrome, and death.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors in the Development of Rectus Sheath Hematoma and Treatment Modalities

Dalcı

Topal

Saritaş

et al. 2020

Preprint

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Aim: In this study,we aim to present the clinical features of patients with Rectus Sheath Hematoma (RSH), therapeutic management and results. Methods: The study included patients who were diagnosed with and received treatment due to spontaneous rectus sheath hematoma between the years 2010 and 2020. The demographic and clinical features of the patients,history of anticoagulant drug use and indication for anticoagulant drugs, laboratory parameters and radiological findings at the time of admission to the hospital, diameter of the hematoma, treatment modalities, follow-up parameters were analyzed retrospectively. Results: Our study included fifty-three patients. The median age was 65.7±14,68 years and 63.3% of the patients were over the age of 65 years. Number of female patients was 35. Cases most often had an American Society of Anesthesiologists score of 3 (64.3%). The most frequently used anticoagulant was warfarin (30.1%) and it was most often used due to heart diseases (54.7%).International Normalized Ratio value at the time of admission to the hospital was 1.93+1.18 and the hemoglobin value was 11.2 gr/dl. Average hematoma diameter was 74 mm and the most common stage was Type 1 (75.6%). 90.6% of the patients were followed up conservatively. Average duration of hospital stay being 15.1 days, mortality developed in 8 patients during their hospital stay. Conclusion: Spontaneous RSH should come to mind in elderly female patients who apply to the hospital with acute abdominal pain and are on anticoagulant therapy. Suspecting RSH can render early and true diagnosis possible, thus reducing morbidity and mortality in these patients.

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“…The age of onset is from 38-86 years with a mean of 57 years, 1,2 and is more common in older women than in men with a ratio of 2: 3. Some factors i predispose to this clinical scenario such as: aging, use of anticoagulants or NSAIDs (with an increase in the mortality rate of 25%), 3 haematological disorders (often deficit of factors VII and X) 4 , closed abdominal trauma, obesity, and pregnancy, due to excessive tension on the abdominal wall, violent muscle contraction (labor, coughing, urinating and defecating), vascular malformations, muscle malformations, and impaired renal function (especially in patients being treated with low molecular weight heparin by accumulation of it). 5 Spontaneous presentation is uncommon, and most of the times, there is a previous surgery as the genesis of it, blunt abdominal trauma (vehicle accident) or injury to the epigastric vessel during trocar insertion in procedures such as laparoscopic cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%