The Open Cardiovascular Medicine Journal

ISSN: 1874-1924 ― Volume 13, 2019

Rectus Sheath Hematoma: A Simplified Emergency Surgical Approach

Michael Mantelas1, *, Niki Katsiki2, 3, Polychronis Antonitsis1, Ellada Kyurdzhieva4, Dimitri P Mikhailidis2, Apostolos Hatzitolios3
1 Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
2 Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, University College London (UCL), London NW3 2QG, UK
3 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
4 Department of Anesthesia, AHEPA University Hospital, Thessaloniki, Greece


Rectus sheath hematoma (RSH) is an uncommon clinical event usually associated with trauma or coagulation disorders. It can also occur spontaneously. RSH usually runs a benign course but it can present with hypovolemic shock. When conservative management fails, surgical exploration becomes mandatory. We propose a technique of emergency ligation of the inferior epigastric artery. This is a simple approach as this artery originates at the posterior rectus sheath above the inguinal ligament. This safe technique provides immediate hemodynamic stabilization.

Keywords: Rectus sheath, hematoma, inferior epigastric artery..

Article Information

Identifiers and Pagination:

Year: 2011
Volume: 5
First Page: 4
Last Page: 5
Publisher Id: TOCMJ-5-4
DOI: 10.2174/1874192401105010004

Article History:

Received Date: 2/12/2010
Revision Received Date: 24/12/2010
Acceptance Date: 28/12/2010
Electronic publication date: 4/2/2011
Collection year: 2011

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open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the AHEPA University Hospital St. Kiriakidi 1, 54636 Thessaloniki Greece; Tel: 00302310994843; Fax: 00302310994871; E-mail:


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