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A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications

INTRODUCTION AND IMPORTANCE: Frequently misdiagnosed, the clinical condition of soft tissue hematoma typically emerges following blunt abdominal trauma and/or anticoagulant medication usage, with spontaneous occurrences being infrequent. In this case report, we present a spontaneous rectus sheath an...

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Autores principales: Landolsi, Sana, Othmane, Mohamed Raouf Ben, Touati, Med Dheker, Omry, Ahmed, Khefacha, Fahd, Chebbi, Faouzi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509910/
https://www.ncbi.nlm.nih.gov/pubmed/37657386
http://dx.doi.org/10.1016/j.ijscr.2023.108756
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author Landolsi, Sana
Othmane, Mohamed Raouf Ben
Touati, Med Dheker
Omry, Ahmed
Khefacha, Fahd
Chebbi, Faouzi
author_facet Landolsi, Sana
Othmane, Mohamed Raouf Ben
Touati, Med Dheker
Omry, Ahmed
Khefacha, Fahd
Chebbi, Faouzi
author_sort Landolsi, Sana
collection PubMed
description INTRODUCTION AND IMPORTANCE: Frequently misdiagnosed, the clinical condition of soft tissue hematoma typically emerges following blunt abdominal trauma and/or anticoagulant medication usage, with spontaneous occurrences being infrequent. In this case report, we present a spontaneous rectus sheath and iliopsoas hematomas without obvious classical risk factors. The purpose of presenting this case is to bring attention to this unusual clinical condition and emphasize the role of thorough history and physical examination in determining the suitable course of treatment. CASE REPORT: A 50-year-old woman with no medical history presented at the emergency room due to sudden asthenia and abdominal pain. Physical examination revealed a painful 20 cm hypogastric mass and left lumbar swelling causing leg bending. Lab tests indicated anemia and normal coagulation. CT scans showed significant hematomas in the left rectus and psoas muscles. Intensive monitoring and supportive measures stabilized her condition without resorting to surgery. CLINICAL DISCUSSION: Soft tissue hematomas, notably in the rectus sheath or iliopsoas muscle, are rare but potentially severe conditions. Their pathophysiology is not fully understood, and risk factors include age, anticoagulant use, and comorbidities. Diagnosis involves abdominal examination, anemia, and CT findings. Management varies based on symptom severity and blood loss, ranging from conservative approaches to surgery or embolization. CONCLUSION: Swift identification and effective handling of soft tissue hematomas hold utmost importance. The thorough history-taking and comprehensive physical examination play pivotal roles within this protocol. While supportive care constitutes the primary mode of management, instances arise where surgical intervention or vascular embolization becomes imperative for hematomas unresponsive to treatment and presenting hemodynamic instability.
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spelling pubmed-105099102023-09-21 A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications Landolsi, Sana Othmane, Mohamed Raouf Ben Touati, Med Dheker Omry, Ahmed Khefacha, Fahd Chebbi, Faouzi Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Frequently misdiagnosed, the clinical condition of soft tissue hematoma typically emerges following blunt abdominal trauma and/or anticoagulant medication usage, with spontaneous occurrences being infrequent. In this case report, we present a spontaneous rectus sheath and iliopsoas hematomas without obvious classical risk factors. The purpose of presenting this case is to bring attention to this unusual clinical condition and emphasize the role of thorough history and physical examination in determining the suitable course of treatment. CASE REPORT: A 50-year-old woman with no medical history presented at the emergency room due to sudden asthenia and abdominal pain. Physical examination revealed a painful 20 cm hypogastric mass and left lumbar swelling causing leg bending. Lab tests indicated anemia and normal coagulation. CT scans showed significant hematomas in the left rectus and psoas muscles. Intensive monitoring and supportive measures stabilized her condition without resorting to surgery. CLINICAL DISCUSSION: Soft tissue hematomas, notably in the rectus sheath or iliopsoas muscle, are rare but potentially severe conditions. Their pathophysiology is not fully understood, and risk factors include age, anticoagulant use, and comorbidities. Diagnosis involves abdominal examination, anemia, and CT findings. Management varies based on symptom severity and blood loss, ranging from conservative approaches to surgery or embolization. CONCLUSION: Swift identification and effective handling of soft tissue hematomas hold utmost importance. The thorough history-taking and comprehensive physical examination play pivotal roles within this protocol. While supportive care constitutes the primary mode of management, instances arise where surgical intervention or vascular embolization becomes imperative for hematomas unresponsive to treatment and presenting hemodynamic instability. Elsevier 2023-08-29 /pmc/articles/PMC10509910/ /pubmed/37657386 http://dx.doi.org/10.1016/j.ijscr.2023.108756 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Landolsi, Sana
Othmane, Mohamed Raouf Ben
Touati, Med Dheker
Omry, Ahmed
Khefacha, Fahd
Chebbi, Faouzi
A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications
title A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications
title_full A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications
title_fullStr A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications
title_full_unstemmed A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications
title_short A rare case report: Spontaneous rectus sheath and iliopsoas hematomas: Clinical presentation, management, and implications
title_sort rare case report: spontaneous rectus sheath and iliopsoas hematomas: clinical presentation, management, and implications
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509910/
https://www.ncbi.nlm.nih.gov/pubmed/37657386
http://dx.doi.org/10.1016/j.ijscr.2023.108756
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