Edit concept Create issue ticket

Abdominal Wall Hematoma

Abdominal Wall Haematoma


Presentation

  • An 87-year-old male patient known to have polycythemia vera presented at the hospital as an acute abdominal emergency.[ncbi.nlm.nih.gov]
  • The patient was admitted with a giant hematoma presenting with pleural effusion, anemia and weight loss on postoperative 30th day after a blunt trauma. Computerized tomography analysis revealed a hematoma extending from axilla to the gluteus.[ncbi.nlm.nih.gov]
  • We present a patient with chronic renal insufficiency who developed a massive posttraumatic abdominal wall hematoma after a single therapeutic dose of enoxaparin administered during workup of chest pain.[ncbi.nlm.nih.gov]
  • We report a case of a 30-year-old male patient who presented with a huge abdominal wall hematoma 60 minutes after laparoscopic appendectomy. During surgery there had been no sign of abdominal wall bleeding.[ncbi.nlm.nih.gov]
  • The etiologies, presenting findings, diagnostic studies, and modes of therapy reported for abdominal wall hematomas are reviewed.[ncbi.nlm.nih.gov]
Soft Tissue Mass
  • […] bhau Infectious Diseases Liver abscess Apes Radiology And Nuclear Medicine Soft tissue mass meri Radiology And Nuclear Medicine Infiltrative anterior abdominal wall mass. Differentials include soft tissue sarcoma, fibrosarcoma and Desmond tumor.[app.figure1.com]
Abdominal Pain
  • Although it is a very rare entity, rectus sheath hematoma should be included in the differential diagnosis of every pregnant patient who presents with abdominal pain.[degruyter.com]
  • A fifty-seven-year-old male patient on warfarin therapy presented to the emergency department with severe abdominal pain that had started after a cough episode and persisted for four days.[ncbi.nlm.nih.gov]
  • Acute abdominal pain or painful mass in the abdominal wall may be the primary symptoms of SAWH. Carnett's test [4] is useful for differentiating abdominal wall pain from intra-abdominal pain.[cmj.org]
  • In severely coughing patients, sudden abdominal pain together with an abdominal painful mass, must alert physicians about the diagnosis of abdominal wall hematoma, especially in patients who are under anticoagulant and antiaggregant therapy.[link.springer.com]
  • Case report: We report a 52 year old female who presented with fever, myalgia and abdominal pain. Dengue IgM was positive. On the 6th day she developed a tender lump over left abdominal wall which increased in size rapidly.[journals.sjp.ac.lk]
Abdominal Mass
  • mass is found which does not move with respiration.[howmed.net]
  • mass in hypovolemic shock.[kjccm.org]
  • The ability to appreciate an intra-abdominal mass is ordinarily degraded with contraction of the rectus muscles.[physiotherapy-treatment.com]
  • mass would be less tender Cullen sign: Periumbilical ecchymosis with retroperitoneal / abdominal wall injury Diagnostic testing Laboratory evaluation General trauma labs Diagnostic imaging Plain films: AP pelvis, CXR, lateral C spine U/S Hemodynamically[fprmed.com]
  • At 4:00 am, the patient developed severe RLQ pain with a progressively expanding abdominal mass. Her systolic blood pressure was 180 mmHg and her heart rate was 150 beats/minute.[med.ucla.edu]
Abdominal Tenderness
  • Physical examination revealed lower right quadrant pain with involuntary guarding and rebound abdominal tenderness at Mcburney s point. He had 30 IMC. The rest were normal. Laboratory tests showed leukocytosis and neutrophilia.[ispub.com]
  • Once again, physical examination found nothing unusual except right upper abdominal tenderness. Her blood tests, including coagulation parameters, returned normal.[panafrican-med-journal.com]
  • DISCUSSION In 1926, Carnett described a test to differentiate pain originating from the abdominal wall versus pain arising from intra-abdominal pathology. 13 The test involves placing the patient supine and the site of maximal abdominal tenderness is[pmj.bmj.com]
  • ., lying, sitting, standing) Pain not related to meals or bowel function No findings of an intra-abdominal process (see Table 1 ) Abdominal tenderness unchanged or increased when abdominal wall is tensed (positive Carnett's sign) Discrete, tender pain[aafp.org]
Abdominal Wall Pain
  • Carnett's test [4] is useful for differentiating abdominal wall pain from intra-abdominal pain. It might also present with dysuria or intestinal obstruction if the hematoma displaces the urinary bladder or the intestines.[cmj.org]
  • Furthermore, abdominal wall pain is often chronic, nagging and nonprogressive.[aafp.org]
  • While there are many causes of abdominal wall pain, 2 this patient’s presentation was more consistent with abdominal muscle pathology.[ultrasoundoftheweek.com]
Systolic Murmur
  • There was no significant finding on physical examination other than a mild systolic murmur at the apical region.[link.springer.com]
Excitement
  • Less Traveled » Abdominal Wall nerve entrapment 6 Replies, The Road Less Traveled Advertisement Hysterectomy News November 24,2018 CURRENT NEWS HysterSisters Takes On Partner To Manage Continued Growth And Longevity I have news that is wonderful and exciting[hystersisters.com]
Dysarthria
  • She had complained of left-sided paralysis with dysarthria and the symptoms gradually worsened.[kjccm.org]

Workup

  • We present a patient with chronic renal insufficiency who developed a massive posttraumatic abdominal wall hematoma after a single therapeutic dose of enoxaparin administered during workup of chest pain.[ncbi.nlm.nih.gov]
  • The patient was discharged from the hospital without further complication following an extensive workup and 48 hours of observation. Pathophysiology, evaluation, and treatment are then discussed in detail.[ncbi.nlm.nih.gov]

Treatment

  • In the latter case, although conservative treatment is possible, hospital stay is prolonged and large amounts of blood-bank resources are consumed.[ncbi.nlm.nih.gov]
  • Effect of Sex: 2-3 times more common in females due to decreased muscle mass and also during pregnancy. [5]Treatment: Treatment depends on the extent of injury and haematoma formation. 1.[howmed.net]
  • The patient was not stabilized by conservative treatment, and inferior epigastric artery injury was confirmed on angiography.[ncbi.nlm.nih.gov]
  • Pathophysiology, evaluation, and treatment are then discussed in detail.[ncbi.nlm.nih.gov]
  • The rarity and the failure to consider the diagnosis might lead to delay in treatment and unnecessary surgery.[cmj.org]

Prognosis

  • What Is the Prognosis for Hematoma? Blood vessels are routinely injured and may leak blood causing hematomas or blood clots. Depending upon their size and location, hematomas may be insignificant or may cause life-threatening damage.[emedicinehealth.com]
  • The location of a hematoma plays a role in its prognosis . From Reviewed by: Tova Alladice, M.D. American Board of Physical Medicine & Rehabilitation[rxlist.com]

Etiology

  • The etiologies, presenting findings, diagnostic studies, and modes of therapy reported for abdominal wall hematomas are reviewed.[ncbi.nlm.nih.gov]
  • Abdominal wall muscle hematomas are rarely fatal, and encompass a wide spectrum of severity depending on size, etiology, and associated complications; but because of their rarity may be misdiagnosed clinically.[kjccm.org]
  • View/Print Table TABLE 3 Etiology of Abdominal Wall Pain Etiology Comments Diagnosis Hernia Protuberance in abdominal wall that usually decreases in size when patient is supine Abdominal CT scanning, abdominal ultrasonography, herniography Rectus nerve[aafp.org]
  • Patients present with varying symptoms, but the most common features are abdominal pain and a mass in the lower abdomen, most frequently on the right side. [1] , [2] An abdominal wall hematoma has multiple possible etiologies, including antithrombotic[onlinejets.org]

Epidemiology

  • Anticoagulant-related bleeding: clinical epidemiology, prediction, and prevention. Am J Med . 1993 ; 95 : 315–328. Crossref Medline Google Scholar 3 Cherry WB, Mueller PS. Rectus sheath hematoma: review of 126 cases at a single institution.[circ.ahajournals.org]
  • Landefeld CS, Beyth RJ (1993) Anticoagulant-related bleeding: clinical epidemiology, prediction and prevention. Am J Med 95: 315-328. Coon WW, Willis PW 3rd (1974) Hemorrhagic complications of anticoagulant therapy. Arch Intern Med 133: 386-392.[omicsonline.org]
  • Epidemiology Frequency International Rectus sheath hematoma is an uncommon, but not rare, cause of abdominal pain.[reference.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology, evaluation, and treatment are then discussed in detail.[ncbi.nlm.nih.gov]
  • Abdominal Wall Trauma Background Injury to abdominal wall Contusions Strong abdominal muscle contractions Strenuous activity Coughing / valsalva (repeated) Commonly missed diagnosis Pathophysiology Injury mechanism: Seatbelt injuries Can cause avulsion[fprmed.com]
  • Pathophysiology Rectus sheath hematomas (RSHs) are generally caused either by rupture of one of the epigastric arteries or by a muscular tear with shearing of a small vessel.[reference.medscape.com]

Prevention

  • We conclude that trocar injury is a potentially preventable complication in laparoscopic surgery if certain precautions are taken.[ncbi.nlm.nih.gov]
  • Computerized tomography or ultrasonography of the abdomen can aid in making the diagnosis and preventing unnecessary surgical intervention.[ncbi.nlm.nih.gov]
  • For means to prevent intraoperative bleeding and the occurrence of abdominal wall hematoma, we studied the course of the inferior epigastric arteries and the ascending branch of the deep circumflex iliac artery in 21 human cadavers.[ncbi.nlm.nih.gov]
  • It is indicated for the prevention of systemic embolism in patients with prosthetic heart valves or atrial fibrillation and for the primary and secondary prevention of venous thromboembolism [ 2 , 9 ].[omicsonline.org]
  • Enoxaparin plus compression stockings compared with compression stockings alone in the prevention of venous thromboembolism after elective neurosurgery. N Engl J Med 1998; 339: 80–85. 3). Weitz JI. Low-molecular-weight heparins.[kjccm.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!