Retroperitoneal and rectus sheath hematomas

Surg Clin North Am. 2014 Feb;94(1):71-6. doi: 10.1016/j.suc.2013.10.007. Epub 2013 Oct 26.

Abstract

The retroperitoneum is rich in vascular structures and can harbor large hematomas, traumatic or spontaneous. The management of retroperitoneal hematomas depends on the mechanism of injury and whether they are pulsatile/expanding. Rectus sheath hematomas are uncommon abdominal wall hematomas secondary to trauma to the epigastric arteries of the rectus muscle. The common risk factors include anticoagulation, strenuous exercise, coughing, coagulation disorders, and invasive procedures on/through the abdominal wall. The management is largely supportive, with the reversal of anticoagulation and transfusions; angioembolization may be necessary.

Keywords: Hematomas; Rectus sheath; Retroperitoneal; Retroperitoneum.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use
  • Blood Transfusion
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Embolization, Therapeutic
  • Hematoma / diagnosis
  • Hematoma / etiology*
  • Hematoma / surgery*
  • Humans
  • Multiple Trauma / diagnosis
  • Multiple Trauma / surgery
  • Rectus Abdominis / blood supply
  • Rectus Abdominis / surgery*
  • Retroperitoneal Space / blood supply
  • Retroperitoneal Space / surgery*
  • Risk Factors

Substances

  • Anticoagulants