Spontaneous Rectus Sheath Hematoma in Cardiac Inpatients: A Single Center Experience

Gündeş, Ebubekir; Çetin, Durmuş Ali; Aday, Ulaş; Çiyiltepe, Hüseyin; Değer, Kamuran Cumhur; Uzun, Orhan; Senger, Aziz Serkan; Polat, Erdal; Duman, Mustafa

doi:10.5505/tjtes.2017.67672

Cited by 4 publications

(11 citation statements)

References 15 publications

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“…This study showed that there was an increase in hematoma size as the SRSH type advanced from 1 to 3. This is consistent with the literature data [16].…”

Section: Discussionsupporting

confidence: 94%

“…Rarely, mortality can occur in SRSH cases (about 4% on the average) [5, 7]. In the literature, mortality seems to be associated more with serious comorbid diseases, anticoagulant therapies, broad SRSHs, increased number of blood transfusions, and upper gastrointestinal system bleedings [16, 19]. There was no mortality in the present study.…”

Section: Discussionmentioning

confidence: 48%

“…In such cases, anticoagulant and antiaggregant therapies need to be discontinued until the bleeding is controlled. In patients who do not respond to conservative treatment, are unstable hemodynamically and have uncontrollable bleeding or a hematoma continually increasing in size or an infected complicated hematoma and patients who show severe peritoneal irritation or signs of abdominal compartment syndrome, an angiography should be performed to identify the bleeding artery radiologically, coil or gel embolization should be applied to the bleeding vessel, or the hematoma should be drained surgically and the bleeding artery ligatured [16]. In their retrospective study involving 29 patients, Gradauskas et al observed that 5 patients (17.2%) had the signs and symptoms of hypovolemic shock and 4 of them had to undergo embolization, which resulted successful in all of them [17].…”

Section: Discussionmentioning

confidence: 99%

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Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

Karapolat

TAŞDELEN

Korkmaz

2019

Emergency Medicine International

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Introduction. Spontaneous rectus sheath hematoma (SRSH) is characterized by bleeding within the rectus abdominis muscle sheath, one of the rare causes of acute abdominal pain. Early diagnosis is imperative in SRSH to prevent complications and the treatment is usually conservative. We intended to present in this study our experience with SRSH patients with respect to diagnostic evaluation and management of their disease. Materials and Methods. In this retrospective study, 14 patients who had received treatment for SRSH in our clinic between January 2012 and December 2017 were assessed in terms of demographic and clinical characteristics, comorbidities, laboratory parameters, diagnostic approach methods, treatment practices, length of hospital stay, and patient outcomes. Results. The patients consisted of 10 (71.4%) females and 4 males (28.6%). The age of the patients ranged between 47 and 93 with a mean age of 66.5 ± 12.1. Anticoagulant treatments were being administered to 5 (35.7%) patients, antiplatelet treatments to 4 (28.5%) patients, and both anticoagulant and antiplatelet treatments to 4 (28.5%) patients. The most common triggering factor was severe cough and the most common initial symptom acute abdominal pain (71.4%). In physical examinations, the entire patients had generalized abdominal tenderness, 10 (71.4%) voluntary guarding and 7 (50%) a right lower quadrant mass. The diagnosis was confirmed by abdominal ultrasonography and computed tomography. Based on the computed tomography findings, the disease was classified as Type 2 found in 9 (64.3%) patients, Type 1 in 3 (21.4%) patients, and Type 3 in 2 (14.2%) patients. All the patients were treated conservatively. They were hospitalized for 1 to 23 days. There was no mortality. All the patients were followed up between 3 months and 2 years and no recurrence was recorded. Conclusion. Considering the presence of SRSH particularly in older female patients who use anticoagulant drugs and have newly developed an abdominal pain and a palpable mass after coughing spells is the key to make an early and correct diagnosis and to prevent possible morbidity and mortality with an appropriate treatment method.

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“…This study showed that there was an increase in hematoma size as the SRSH type advanced from 1 to 3. This is consistent with the literature data [16].…”

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

Karapolat

TAŞDELEN

Korkmaz

2019

Emergency Medicine International

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“…8,13 RSH is more common among women in their sixties. 6,10 This is attributed to women's having a smaller amount of rectus abdominis muscles and reduction in the flexibility of epigastric veins with increasing age due to atheromatous changes in the epigastric vein walls. Another reason for increased incidence of SRSH in the old age is increased use of anticoagulant and antiaggregant drugs by the elderly.…”

Section: Discussionmentioning

confidence: 99%

“…7 In the literature, data relating to rectus sheath hematoma are based on single center experiences and series with limited number of patients. 3,[7][8][9][10] In this study; we aim to analyze and discuss, in the light of the literature, the clinical features of patients diagnosed with rectus sheath hematoma in our clinic over a period of 10 years, and the therapeutic management and therapeutic results of SRSH.…”

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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Rectus sheath hematoma: conservative, endovascular or surgical treatment? A single-center artificial neural network analysis

Angeramo

Méndez

Eyheremendy

et al. 2022

Eur J Trauma Emerg Surg

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Spontaneous Rectus Sheath Hematoma in Cardiac Inpatients: A Single Center Experience

Abstract: BACKGROUND: This study presents the relationship between mortality and spontaneous rectus sheath hematoma (RSH) in inpatients receiving anticoagulant and antiaggregant treatment for cardiac pathology at cardiology and cardiovascular surgery clinics.

Cited by 4 publications

References 15 publications

Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

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

Rectus sheath hematoma: conservative, endovascular or surgical treatment? A single-center artificial neural network analysis

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