Conservative management of hematoma of the rectus sheath, unusual cause of acute abdomen: A case report

Rectus sheath hematoma (RSH) is an accumulation of blood within the rectus sheath, secondary to rupture of the epigastric arteries. It is a rare condition, accounting for 1.6-1.8% of abdominal pain cases. It is more frequently observed in women, over the age of 50. Predisposing factors include the long-term use of anticoagulants, antiplatelets, steroids or immunosuppressants, prolonged INR, pregnancy, cardiovascular disease, hematological disease, hypertension, and diabetes. The symptoms are typically described as persistent and non-radiating acute abdominal pain that classically worsens with movements involving the abdominal wall (Carnett’s sign). Cullen’s signs (periumbilical ecchymosis) and Gray Turner’s signs (flank ecchymosis) may also be present. In stable patients, the management is conservative