2019 Volume 39 Issue 7 Pages 1297-1301
The patient was a 68-year-old woman who visited our hospital with the chief complaint of persistent pain in her left abdomen. She had previously undergone incisional hernia repair. She was taking only antihypertensive medication. On physical examination, an immovable mass with tenderness could be palpated in the left abdomen. Blood examination revealed a slight increase of the serum in C-reactive protein level (0.58 mg/dL) and slight decrease of the blood hemoglobin level (11.5 g/dL), with no evidence of coagulation abnormalities. Abdominal contrast-enhanced CT revealed a hematoma in the left abdominal wall, measuring approximately 4 cm in diameter, with contrast extravasation. Based on these findings, the patient was diagnosed as having non-traumatic rectus sheath hematoma (RSH). She was admitted to our hospital for conservative therapy, because her condition was stable. Since the subjective symptoms gradually improved, she was discharged after 4 days of admission. RSH is a relatively rare condition, with a hematoma forming inside the sheath of the rectus abdominis muscle as a result of rupture of the superior or inferior epigastric arteriovenous vessels, often precipitated by violent contractions of the abdominal muscles. Herein, we have reported a case of non-traumatic RSH caused by a coughing fit, with a review of the relevant literature.
