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