Tanısal laparoskopi sonrası rektus kılıf hematomunun konservatif tedavisi

Year 2022, Volume: 2 Issue: 3, 639 - 646, 26.12.2022

Tolga Kalaycı , Murat Kartal

https://doi.org/10.56061/fbujohs.1143146

Abstract

Bu olgu sunumu, sağ alt kadran ağrısı olan bir hastada tanısal laparoskopi sonrası gelişen rektus kılıf hematomu tanısını ve konservatif tedavi sürecini sunmayı amaçlamaktadır. Altmış yedi yaşında bayan hasta yaklaşık beş gündür karın ağrısı, sağ kasık ağrısı ve mide bulantısı şikayetleriyle başvurdu. Hastanın asetilsalisilik asit ile takip edilen koroner arter hastalığı vardı. Karın muayenesinde derin palpasyonda hassasiyet ve defans mevcuttu. Laboratuvar parametrelerinde, ultrasonografide (USG) ve bilgisayarlı tomografide (BT) patoloji görülmedi. Hastanın şikayetlerinin medikal tedaviye rağmen düzelmemesi üzerine laparoskopik apendektomi yapıldı. Hastanın postoperatif altıncı saatinde sol alt karın duvarında kitle tespit edildi. Hastanın kontrol hemogram düzeyi 10,8 g/L, preoperatif döneme göre 3,7 g/L hemoglobin düşüşü, idi. BT'de sol rektus kılıf hematomu tespit edildi. Hematom konservatif olarak tedavi edildi. Yatışının 12. gününde hemoglobin değeri 10,9 g/L olan hasta komplikasyonsuz olarak taburcu edildi.

Keywords

Karın rektus kası, Apendektomiler, hematom, cerrahi tanı tekniği.

Conservative treatment of rectus sheath hematoma after diagnostic laparoscopy

Abstract

This case report aims to present rectus sheath hematoma's diagnosis and conservative treatment process after diagnostic laparoscopy in a patient with right lower quadrant pain. A sixty-seven-year-old lady was admitted with abdominal pain, right inguinal pain, and nausea for about five days. She had coronary artery disease followed by acetylsalicylic acid. On physical examination of the abdomen, there was tenderness and defence on deep palpation. No pathology was seen on laboratory parameters, ultrasonography (USG) and computed tomography (CT). Despite medical treatment, the patient's complaints did not improve, so a laparoscopic appendectomy was performed. A mass was detected in the left lower abdominal wall of the patient at the sixth postoperative hour. The control hemogram level of the patient was 10.8 g/L, a 3.7 g/L haemoglobin decrease compared to the preoperative period. A left rectus sheath hematoma was detected on CT. The hematoma was treated conservatively. On the 12th day of her hospitalisation, the patient with a haemoglobin value of 10.9 g / L was discharged without complications.

Keywords

Abdomen rectus muscle, Appendectomies, hematoma, surgical diagnostic technic.

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