title: [Acute abdomen in abdominal wall hemorrhage in anticoagulation].
abstract: 10 patients with a history of systemic anticoagulation presented with an acute abdomen which proved to be due to a rectus sheath hematoma. Four patients gave a history of antecedent trauma. The prothrombin time was prolonged beyond the therapeutic range in 8 patients and therapeutic in two. The diagnosis of rectus sheath hematoma was made by non-invasive imaging (sonography [n = 8], CT-scan) in 9 patients and by operative exploration in one. 8 patients were treated non-operatively and one patient required a delayed evacuation of the infected hematoma. One patient died from myocardial infarction. We conclude that a careful history, physical examination and prothrombin time, in combination with radiologic evaluation (sonography, CT-scan) can confirm the suspected diagnosis of rectus sheath hematoma. It is important to think of this specific hemorrhagic complication induced by anticoagulation to prevent unnecessary surgery.
authors.affiliation: Klinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
authors.forename: B
authors.initials: B
authors.lastname: Egger
authors.forename: W
authors.initials: W
authors.lastname: Schweizer
authors.forename: H E
authors.initials: HE
authors.lastname: Wagner
mesh_terms: D000006:Abdomen, Acute / Q000139:chemically induced*; D000009:Abdominal Muscles / Q000098:blood supply*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000139:chemically induced*
chemical_list: D000925:Anticoagulants
vernacular_title: Das akute Abdomen bei Bauchwandblutung unter Antikoagulation.