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Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?

Yıl 2021, Cilt: 16 Sayı: 2, 84 - 89, 28.04.2021

Öz

Spontaneous rectus sheath hematomas may occur spontaneously due to anticoagulant use and cough. Rectus sheath hematoma frequency increased with more use of anticoagulants. This study was aimed to evaluate the success of CT, which has a high sensitivity in detecting rectus sheath hematomas, in predicting whether spontaneous rectus sheath hematomas are caused by coagulopathy or not. Cases with rectus sheath hematoma in the radiology archive of our hospital were included in the study. Cases with a history of trauma, surgery, or abdominal injection were excluded from the study. Twenty-four cases evaluated as spontaneous rectus sheath hematoma were divided into two groups according to the international normalized ratio (INR) result as anticoagulant-related rectus sheath hematoma (14 cases) and non-anticoagulant-related rectus sheath hematoma (10 cases). Fluid cellular level in the hematoma (1), heterogeneity (2), localization at the infra-umbilical level (3) and stranding of subcutaneous fat tissue in the abdominal wall (4), were evaluated as anticoagulant-related rectus sheath hematoma CT findings. Hematoma at the supra-umbilical or umbilical level was considered as hematoma unrelated to anticoagulant use. Diagnostic accuracies were confirmed by laboratory results. Categorical data were compared with chi-square and numerical data using Mann–Whitney U test. While 17 (70.8 %) of the cases were female, only 7 (29.2%) were male. While rectus hematomas are mostly seen in isolation at the umbilical or supraumbilical level of the rectus muscle in the group with no anticoagulant use, it is mostly seen at the infra-umbilical level in the group with anticoagulant use (p = 0.001). Stranding in subcutaneous fatty tissue accompanying rectus hematoma is mostly seen in the group with anticoagulant use (p <0.001). Besides, the incidence of heterogeneity in hematoma due to anticoagulant use has increased (p = 0.035). No statistically significant difference was found between the two groups in terms of fluid cellular levels in the hematoma. In spontaneous rectus hematomas accompanied by coagulability, the hematoma is mostly localized at the infra-umbilical level. Also, subcutaneous fatty tissue stranding is more common.

Kaynakça

  • Fitzgerald, J.E., Fitzgerald, L.A., Anderson, F.E., and Acheson, A.G., (2009). The changing nature of rectus sheath haematoma: case series and literature review. International Journal of Surgery (London, England), 7(2):150-4. https://www.sciencedirect.com/science/article/pii/S1743919109000181. Access Date:02.11.2020).
  • Ozaras, R., Yılmaz, M.H., Tahan, V., Uraz, S., Yiğitbaşı, R., and Senturk, H., (2003). Spontaneous hematoma of the rectus abdominis muscle: a rare cause of acute abdominal pain in the elderly. Acta chirurgica belgica. 103(3):332-3. https://www.tandfonline.com/doi/abs/10.1080/00015458.2003.11679435? casa_token=BPvpQiZlZKcAAAAA:mJcWOvXj1Zs_TwbCnBagU_zJ01lrRCQD5uVB-PTljUzbLmZwH-10ntTtQRAzQARWamaZBBVylPViJg (Access Date: 25.10.2020).
  • Swensen, S.J., McLeod, R.A., and Stephens, D.H., (1984). CT of Extracranial hemorrhage and hematomas. AJR American Journal of Roentgenology, 143(4):907-12. https://www.ajronline.org/doi/abs/10.2214/ajr.143.4.907 (Access Date:02.01.2021).
  • Berna, J.D., Garcia-Medina, V., Guirao, J., and Garcia-Medina, J., (1996). Rectus sheath hematoma: diagnostic classification by ct. Abdominal Imaging. 21(1):62-4. https://link.springer.com/article/10.1007/s002619900011 (Access Date: 17.10.2020)
  • Contrella, B.N., Park, A.W., Wilkins, L.R., and Sheeran, D., Hassinger, T.E., Angle, J.F., (2019). Spontaneous rectus sheath hematoma: factors predictive of conservative management failure. Journal of vascular and interventional radiology: JVIR. 31(2):323-30. https://www.sciencedirect.com/science/article/pii/S1051044319305718. (Access Date: 21.10.2020).
  • Cherry, W.B. and Mueller, P.S., (2006). Rectus sheath hematoma: review of 126 cases at a single institution. Medicine. 85(2):105-10. https://journals.lww.com/md-journal/Fulltext/2006/03000/Rectus_Sheath_Hematoma__Review_of_126_Cases_at_a.5.aspx. (Access Date: 10.10.2020).
  • Macias-Robles, M.D., Peliz, M.G., and Gonzalez-Ordonez, A.J., (2005). Prophylaxis with Enoxaparin can Produce a Giant Abdominal Wall Haematoma when Associated with Low Doses of Aspirin Among Elderly Patients Suffering Cough Attacks. Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis. 16(3):217-9. https://europepmc.org/article/med/15795543. (Access Date: 09.10.2020)
  • Hatjipetrou, A., Anyfantakis, D., and Kastanakis, M., (2015). Rectus sheath hematoma: a review of the literature. International Journal of Surgery (London, England), 13:267-71. https://www.sciencedirect.com/science/article/pii/S1743919114010309?via%3Dihub. (Access Date: 23.10.2020).
  • Nishimura, R.A., Otto, C.M., Bonow, R.O., Carabello, B.A., and Erwin, J.P., Guyton RA, et al., (2014). AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the american college of cardiology/american heart association task force on practice guidelines. Journal of the American College of Cardiology, 63(22):2438-88. https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000029 (Access Date: 29.10.2020).
Yıl 2021, Cilt: 16 Sayı: 2, 84 - 89, 28.04.2021

Öz

Kaynakça

  • Fitzgerald, J.E., Fitzgerald, L.A., Anderson, F.E., and Acheson, A.G., (2009). The changing nature of rectus sheath haematoma: case series and literature review. International Journal of Surgery (London, England), 7(2):150-4. https://www.sciencedirect.com/science/article/pii/S1743919109000181. Access Date:02.11.2020).
  • Ozaras, R., Yılmaz, M.H., Tahan, V., Uraz, S., Yiğitbaşı, R., and Senturk, H., (2003). Spontaneous hematoma of the rectus abdominis muscle: a rare cause of acute abdominal pain in the elderly. Acta chirurgica belgica. 103(3):332-3. https://www.tandfonline.com/doi/abs/10.1080/00015458.2003.11679435? casa_token=BPvpQiZlZKcAAAAA:mJcWOvXj1Zs_TwbCnBagU_zJ01lrRCQD5uVB-PTljUzbLmZwH-10ntTtQRAzQARWamaZBBVylPViJg (Access Date: 25.10.2020).
  • Swensen, S.J., McLeod, R.A., and Stephens, D.H., (1984). CT of Extracranial hemorrhage and hematomas. AJR American Journal of Roentgenology, 143(4):907-12. https://www.ajronline.org/doi/abs/10.2214/ajr.143.4.907 (Access Date:02.01.2021).
  • Berna, J.D., Garcia-Medina, V., Guirao, J., and Garcia-Medina, J., (1996). Rectus sheath hematoma: diagnostic classification by ct. Abdominal Imaging. 21(1):62-4. https://link.springer.com/article/10.1007/s002619900011 (Access Date: 17.10.2020)
  • Contrella, B.N., Park, A.W., Wilkins, L.R., and Sheeran, D., Hassinger, T.E., Angle, J.F., (2019). Spontaneous rectus sheath hematoma: factors predictive of conservative management failure. Journal of vascular and interventional radiology: JVIR. 31(2):323-30. https://www.sciencedirect.com/science/article/pii/S1051044319305718. (Access Date: 21.10.2020).
  • Cherry, W.B. and Mueller, P.S., (2006). Rectus sheath hematoma: review of 126 cases at a single institution. Medicine. 85(2):105-10. https://journals.lww.com/md-journal/Fulltext/2006/03000/Rectus_Sheath_Hematoma__Review_of_126_Cases_at_a.5.aspx. (Access Date: 10.10.2020).
  • Macias-Robles, M.D., Peliz, M.G., and Gonzalez-Ordonez, A.J., (2005). Prophylaxis with Enoxaparin can Produce a Giant Abdominal Wall Haematoma when Associated with Low Doses of Aspirin Among Elderly Patients Suffering Cough Attacks. Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis. 16(3):217-9. https://europepmc.org/article/med/15795543. (Access Date: 09.10.2020)
  • Hatjipetrou, A., Anyfantakis, D., and Kastanakis, M., (2015). Rectus sheath hematoma: a review of the literature. International Journal of Surgery (London, England), 13:267-71. https://www.sciencedirect.com/science/article/pii/S1743919114010309?via%3Dihub. (Access Date: 23.10.2020).
  • Nishimura, R.A., Otto, C.M., Bonow, R.O., Carabello, B.A., and Erwin, J.P., Guyton RA, et al., (2014). AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the american college of cardiology/american heart association task force on practice guidelines. Journal of the American College of Cardiology, 63(22):2438-88. https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000000029 (Access Date: 29.10.2020).
Toplam 9 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Şükrü Şahin 0000-0001-6920-4317

Mehmet Ali Gedik 0000-0002-1548-0444

Yayımlanma Tarihi 28 Nisan 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 16 Sayı: 2

Kaynak Göster

APA Şahin, Ş., & Gedik, M. A. (2021). Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?. Medical Sciences, 16(2), 84-89.
AMA Şahin Ş, Gedik MA. Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?. Medical Sciences. Nisan 2021;16(2):84-89.
Chicago Şahin, Şükrü, ve Mehmet Ali Gedik. “Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?”. Medical Sciences 16, sy. 2 (Nisan 2021): 84-89.
EndNote Şahin Ş, Gedik MA (01 Nisan 2021) Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?. Medical Sciences 16 2 84–89.
IEEE Ş. Şahin ve M. A. Gedik, “Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?”, Medical Sciences, c. 16, sy. 2, ss. 84–89, 2021.
ISNAD Şahin, Şükrü - Gedik, Mehmet Ali. “Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?”. Medical Sciences 16/2 (Nisan 2021), 84-89.
JAMA Şahin Ş, Gedik MA. Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?. Medical Sciences. 2021;16:84–89.
MLA Şahin, Şükrü ve Mehmet Ali Gedik. “Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?”. Medical Sciences, c. 16, sy. 2, 2021, ss. 84-89.
Vancouver Şahin Ş, Gedik MA. Can Computed Tomography Predict Whether Spontaneous Rectus Sheath Hematomas Are Caused By Coagulopathy?. Medical Sciences. 2021;16(2):84-9.