April 13, 2009

What Is Rectus Hematoma?

Posted in Category : Hematoma

Rectus hematoma, also known as rectus sheath hematoma, is a rare disease that results in bleeding into the rectus sheath. The bleeding happens due to damage in the rectus muscle or due to damage of the epigastric arteries. Rectus hematoma is often misdiagnosed due to its similarity to common abdominal pain.

The common symptoms of rectus hematoma are acute abdominal pain, accompanied with fever and nausea. The abdominal pain is often sharp and acute and may occur both suddenly or gradually. You will also feel a painful mass in your lower abdomen, which will cause more pain during movement of the body. Depending on the severity of the condition, rectus hematoma is divided into three types – Type I, Type II, and Type III.

There are several causes of rectus hematoma; some of which are mentioned below:

  • Use of anticoagulants
  • Severe coughing (patients with asthma, tuberculosis, pertussis, and other infections of the respiratory system)
  • Pregnancy and labor-related causes
  • External injury
  • Vigorous physical work
  • Surgery
  • Underlying medical disorder

Although rectus hematoma can happen to anyone, pregnant women, elderly people, and people undergoing anticoagulation therapy are more at risk. The disease is usually just a self-limiting troublesome condition but can, in some cases, also prove fatal.

Proper medical diagnosis is the first step in treating this disease. Often it remains undiagnosed because the symptoms mimic common abdominal pain. Also, a proper diagnosis is difficult because it is a rare disease. Diagnosis is usually made with laboratory results and imaging studies. For laboratory tests, blood cell counts, coagulation factors, and arterial or venous blood gas are measured. Imaging studies mostly employ CT scans, MRI scans, and ultrasonography.

The treatments for rectus hematoma include proper rest, use of analgesics, pain management with ice packs, intravenous fluid resuscitation, anticoagulation reversal, and transfusion. Patients with chronic conditions (Type II and Type III) may need to be admitted to hospital for treatment. These patients may also need some surgical treatment to drain out the hematoma and to repair the rectus sheath. Type II rectus hematoma may need 2-4 months to recover, while Type III usually takes more than 3 months. Patients with Type I rectus hematoma generally do not require hospitalization and with proper medical treatment they should recover within a month.

After getting discharged from the hospital it still is important to carry on with the prescribed medication and follow up with the doctor regularly so that the progress can be monitored properly.