title: Management of patients with rectus sheath hematoma: Personal experience.
abstract: OBJECTIVE
  Rectus sheath hematoma (RSH) is a rare clinical entity. It can be mistaken for other intra-abdominal disorders, which can result in diagnostic and therapeutic difficulties. This study was undertaken to analyze the clinical presentation, diagnostic modalities, and management of patients affected with RSH.
  
  
  METHODS
  Between January 2008 and June 2011, eight patients (5 men and 3 women with a mean age of 53 years) with RSH were evaluated according to demographic characteristics, clinical and radiological findings, and methods of treatment.
  
  
  RESULTS
  Six patients developed RSH after anticoagulant therapy; one after local trauma, and one after laparoscopic intervention. Six patients were treated nonsurgically; one patient underwent embolization of the inferior epigastric artery and one underwent ligation of the bleeding vessel. The average hospital stay was 6 days. There were no mortality or thromboembolic complications.
  
  
  CONCLUSIONS
  RSH is a rare nonneoplastic entity that is usually associated with abdominal trauma and/or anticoagulant therapy. The gold standard for diagnosis is computed tomography, and ultrasonography can be used in follow-up. The treatment of choice is nonsurgical therapy because RSH is a self-limited condition. Surgical intervention should be reserved for cases with hemodynamic instability.
authors.affiliation: Section of Endocrine Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy. Electronic address: a.buffone@unict.it.
authors.forename: Antonino
authors.initials: A
authors.lastname: Buffone
authors.affiliation: Section of Emergency and General Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Basile
authors.affiliation: Section of Endocrine Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Costanzo
authors.affiliation: Section of Endocrine Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Veroux
authors.affiliation: Section of Endocrine Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Terranova
authors.affiliation: Section of Radiology, Garibaldi Hospital, Catania, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Basile
authors.affiliation: Section of Endocrine Surgery, University of Catania, Policlinico-Vittorio Emanuele Hospital, Catania, Italy.
authors.forename: Valeriya
authors.initials: V
authors.lastname: Okatyeva
authors.affiliation: Section of Radiology, Delta-LagoSanto Hospital, Ferrara, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Cannizzaro
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D019468:Disease Management; D005260:Female; D006406:Hematoma / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000925:Anticoagulants
keywords: abdominal pain; hematoma; rectus abdominal muscle; treatment