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