Hematoma of the Abdominal Sheath Induced by Cough, A Rare Finding in Clinical Practice: A Case Report

Chin-Chu Wu, A. C. Lin
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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.
咳嗽引起的腹腔鞘血肿,临床实践中的罕见病例:病例报告
我们在此报告了一例咳嗽阵发后直肠鞘血肿(RSH)的手术治疗病例。直肠鞘血肿是一种罕见的急腹症,在急诊科经常被误诊。急诊科接诊了一名 67 岁的女性,主诉腹痛 2 天,疼痛部位位于左上腹。疼痛呈持续性。患者称咳嗽和做某些动作时疼痛加剧。咳嗽时腹部肌肉用力收缩会导致直肌直接撕裂或上腹部动脉破裂,从而形成 RSH,即腹直肌前区积血。
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