Large Hematoma Of Rectus Abdominis Muscle As A Rare Surgical Case In A COVID-19 Patient

L Ratiani, L Gabunia, B Shanshashvili, E Pipia, K Machavariani, V Shoshiashvili, K Ghambashidze, M Namoradze, N Intskirveli


Presented article discusses the case of spontaneous   large hematoma of rectus abdominis muscle, developed in a 63-year-old woman during standard in-hospital treatment of COVID-19.

Diagnosis has been confirmed on the basis of clinical, ultrasound and computed tomography findings. Patient underwent conservative treatment, but due to the increase in size of hematoma and patient’s worsened general condition, emergency surgical hematoma evacuation and ligation of damaged lower epigastric artery was performed.

Postoperative period passed without complications. Patient discharged at home under ambulatory follow-up by surgeon.

According to this case could be concluded that conservative treatment of rectus abdominis muscle large hematoma is not always successful and careful monitoring and proper surgical treatment is needed to prevent complication and save the patient’s life.


Rectus Abdominis Muscle, Hematoma, Bleeding, Extravasation.

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Kumar HS, DiNella R, Janov J, Kaldas C, Smith H. Evaluation of risk factors for rectus sheath hematoma. Sheth. Clin Appl Thromb Hemost. 2016;22:292–296;

Dağ A, Ozcan T, Türkmenoğlu O, et al. Spontaneous rectus sheath hematoma in patients on anticoagulation therapy. Ulus Travma Acil Cerrahi Derg. 2011;17:210–214;

Galyfos G, Karantzikos G, Palogos K, Sianou A, Filis K, Kavouras N. Spontaneous rectus sheath hematoma in the elderly: an unusual case and update on proper management. Case Rep Emerg Med. 2014;2014:675678.

A Balafa O, Koundouris S, Mitsis M, Siamopoulos KC. Unusual case of hemoperitoneum: spontaneous rectus sheath hematoma. Perit Dial Int. 2014;34:134–135.

Tseng GS, Liau GS, Shyu HY, Chu SJ, Ko FC, Wu KA. Expanding refractory rectus sheath hematoma: a therapeutic dilemma. Diagn Interv Radiol. 2012;18:139–141.

Smithson A, Ruiz J, Perello R, Valverde M, Ramos J, Garzo L. Diagnostic and management of spontaneous rectus sheath hematoma. Eur J Intern Med. 2013;24:579–582.

Sandoval O, Kinkead T. Spontaneous rectus sheath hematoma: an unusual cause of gross hematuria. Urology. 2013;82:30–36.

O'Mara MS, Semins H, Hathaway D, Caushaj PF. Abdominal compartment syndrome as a consequence of rectus sheath hematoma. Am Surg. 2003;69:975–977.



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