Taguchi Kana, Kamei Yoshiaki, Kusakabe Erina, Yamashita Michiko, Noda Haruna, Aoki Reina, Nishiyama Kanako, Murakami Akari, Tanaka Hiroaki, Matsuda Megumi, Kido Teruhito, Sato Norio, Takada Yasutsugu
Department of Breast Center, Ehime University Hospital, Japan.
Department of Radiology, Ehime University Graduate School of Medicine, Ehime, Japan.
Radiol Case Rep. 2022 Mar 24;17(5):1737-1740. doi: 10.1016/j.radcr.2022.02.074. eCollection 2022 May.
A non-traumatic abdominal wall hematoma is rare, and occurs occasionally due to coughing, physical activity, or antithrombotic/anticoagulant therapy. The condition is usually unilateral; however, rare bilateral cases have been reported. Here, we report a rare case of a non-traumatic bilateral rectus sheath hematoma. The patient was a 60-year-old woman who was urgently admitted to our hospital due to the occurrence of pneumonia during postoperative chemotherapy for breast cancer. Because she exhibited disseminated intravascular coagulation, a therapy with antibacterial agents, thrombomodulin alpha, and catecholamines was initiated. During hospitalization, hemorrhagic shock due to hematomas in both rectus abdominis muscles was observed without any discernible cause. Subsequent emergency angioembolization was successful, and abdominal computed tomography performed 3 months after the onset of the rectus sheath hematoma confirmed a reduction in the hematoma size.
非创伤性腹壁血肿较为罕见，偶尔因咳嗽、体力活动或抗血栓/抗凝治疗而发生。该病通常为单侧性；然而，也有罕见的双侧病例报道。在此，我们报告一例罕见的非创伤性双侧腹直肌鞘血肿病例。患者为一名60岁女性，因乳腺癌术后化疗期间发生肺炎而紧急入院。由于她出现了弥散性血管内凝血，遂开始使用抗菌药物、重组血栓调节蛋白α和儿茶酚胺进行治疗。住院期间，在无任何明显诱因的情况下，观察到双侧腹直肌出现血肿导致失血性休克。随后的急诊血管栓塞术取得成功，腹直肌鞘血肿发病3个月后进行的腹部计算机断层扫描证实血肿大小有所减小。
