Anticoagulant Therapy and Rectus Sheath Hematoma

Year 2020, , 61 - 65, 02.03.2020

Fatih Üzer , Tülay Özdemir

https://doi.org/10.18521/ktd.460383

Cited By: 1

Abstract

Aim: We reviewed the clinical features, treatment, and
outcomes of 17 patients diagnosed with Rectus Sheath Hematoma.

 

Material method: In this
observational study, patients diagnosed with RSH in Akdeniz University chest
diseases clinic from December 31, 2012, to December 31, 2016  were investigated. RSH was confirmed by
radiological investigations.  Demographic
characteristics, clinic features and comorbidities,  physical examination leading to diagnosis,
laboratory study results , imaging methods, treatment,  and outcomes of 17 patients diagnosed with
RSH  were investigated.

Results :Twelve (70.5%) female and
5 (29.5%) male were followed up due to RSH in our Chest Diseases Clinic between
December 2012 and December 2016. The mean age of all cases was 72.9 (range of
distribution 42-89), while the mean age of female patients was 73.0 (range
54-87) and male 72.2 (range 42-89). The most common presenting symptoms were
abdominal pain (14 cases), hematuria (2 cases) 
and  a case of groin pain. All
patients received anticoagulant treatment (11 enoxaparin sodium, 4 warfarin
sodium, 1 rivaroxaban) except one.  The
diagnosis of RSH was confirmed by ultrasonography in 13 cases and computerized
tomography in 3 other cases. Conservative treatment response was obtained in 11
of the patients, while 6 patients developed hypotensive shock and died.

Conclusion : Rectus sheath hematoma should be considered in the diagnosis of
acute sepsis in patients with subclass low molecular weight heparin (LMWH)
treatment and sudden onset of mass. RSH is more common in women and in patients
using anticoagulants. 

Keywords

anticogulant drugs, heparin, rectus abdominis

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