Spontaneous Hematoma of the Lateral Abdominal Wall Caused by a Rupture of a Deep Circumflex Iliac Artery: Report of Two Cases

Abstract

Expanding hematoma of the abdominal wall is a rare example of acute abdominal disease. We report two cases of lateral abdominal wall hematoma caused by the rupture of a deep circumflex iliac artery, which is a rare cause of an abdominal wall hematoma. Both patients experienced severe abdominal pain after sneezing or coughing. In both cases, computed tomography (CT) findings suggested that active bleeding was continuing. Emergent angiography was therefore performed, and the hematoma was embolized using Spongel or Microcoils. Ultrasound examinations were repeatedly used to monitor the size of the hematoma. The size of the hematoma and patient's pain gradually decreased after embolization. Ultrasound and CT examinations provided useful information for the differential diagnosis of this disease. We conclude that emergent angiography should be performed to control bleeding and avoid any unnecessary surgical procedures in patients with hematoma of the abdominal wall.

Oblique Muscle Hematoma: A Gynecologic Surgery Complication?

“…Rectus and abdominal oblique muscle hematomas are difficult to diagnose because are rare and these presentations could resemble other pathologies. Abdominal pain, back lower pain, fever and ecchymosis are the most frequent symptoms and signs and may simulate acute abdomen or pyelonephritis [2]. In a study conducted by Cherry et al [5] only 17% of the abdominal hematomas present ecchymoses [5].…”

“…Most abdominal wall hematomas occur in rectum sheath, and hematomas within the oblique muscle are unusual. Women over 50 years old present hematomas more often than men, probably due to their muscular fragility [2]. In this article, the authors present a clinical case of a hematoma of the oblique muscle after a gynecologic surgery and its further complications.…”

Spontanoeus Lateral Abdominal Wall Hematoma As A Complication Of Coughing :Case Report And Literature Review

“…Hematomas of the abdominal wall or retroperitoneal cavity have been reported as a cause of acute abdomen (Shimizu et al, 2003). An expanding hematoma of the abdominal wall is a rare example of an acute abdominal disease.…”

“…Anticoagulation and bleeding disorders are well known risk factors for spontaneous hemorrhage and abdominal wall hematomas (Shimizu et al, 2003). They may occur spontaneously or result from trauma, trocar placement or femoral artery catheterization.…”

Want to operate an abdominal lump? Think twice; it might be spontaneous rectus sheath hematoma: a case report

“…Very rarely hematoma may also be formed in the oblique muscle of abdomen. [2][3][4] It is termed as non-traumatic or spontaneous rectus sheath hematoma when it is not associated with any abdominal trauma. 5 Several risk factors have been described like older age, female patient, blunt trauma, injection, platelet function defect, any haematological/coagulation disorder, anticoagulant/antiplatelet therapy, increased intraabdominal pressure (coughing, sneezing, urination, defaecation).…”