Rectus sheath hematoma complicated by deep vein thrombosis

Abstract

A 63-year-old previously healthy female on no medications was admitted in the emergency department due to pain in the left flank. Initially, she was hemodynamically stable. During the initial examination she became unstable. An ultrasound examination showed a large retroperitoneal hematoma, and a computerized tomography showed a hematoma of the rectus sheath as well. The patient was admitted in the Intensive Care Unit. Due to signs of elevated intra-abdominal pressure and deep vein thrombosis of the left lower extremity, a surgical evacuation of the hematoma was performed the day after. It had to be repeated due to continued bleeding 24 hours later. The management and possible sequelae of rectus sheath hematoma are discussed.