Hematoma of the Abdominal Sheath Induced by Cough, A Rare Finding in Clinical Practice: A Case Report
Chin-Chu Wu
Department of Medical Imaging, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Aming Chor-Ming Lin *
Emergency Department, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan and School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
*Author to whom correspondence should be addressed.
Abstract
We report herein a case of rectus sheath hematoma (RSH) following a cough paroxysm treated as surgical intervention. RSH is a rare clinical condition of acute abdomen and often misdiagnosed in the emergency department. A 67-year-old woman presented to the emergency department with complaint of 2-day history of abdominal pain localized in left upper region. The pain was persistent. The patient reported that her pain worsened with coughing and certain movements. Abdominal muscle forceful contraction during coughing causes direct tear of the rectus muscle or rupture of epigastric arteries leading to formation of RSH, which is the accumulation of blood within anterior rectus abdominis muscle.
Keywords: Abdominis muscle, rectus sheath hematoma, abdominal medication, cough paroxysm