Small bowel infarction complicating rectus sheath haematoma in an anticoagulated patient.
BACKGROUND
A rectus sheath haematoma is a difficult condition to diagnose and is usually treated by conservative measures. However, significant sized haematomas can result in severe haemodynamic repercussions, especially in those patients with co-morbidities and anticoagulation.


METHODS
The case reported here is of a 68 year old anticoagulated patient with severe medical co-morbidity who presented with abdominal pain and hypotension. An abdominal CT scan demonstrated a large rectus sheath haematoma and small bowel infarction. The relationship between these two separate causes of an acute abdomen is discussed and imaging findings are illustrated.


CONCLUSIONS
A careful history and a high index of suspicion are necessary to diagnose a rectus sheath haematoma. Further imaging such as CT may be required and if diagnosed early enough, it should be treated aggressively based on the clinical findings.
Dineen
Robert A
RA
Department of Academic Radiology, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.
Lewis
Nina R
NR
Altaf
Nishath
N
D000368:Aged; D005260:Female; D006406:Hematoma / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D007421:Intestine, Small / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D007511:Ischemia / Q000000981:diagnostic imaging / Q000473:pathology*; D009135:Muscular Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D017568:Rectus Abdominis / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed