Department of Radiology, Başakşehir Çam and Sakura City Hospital, İstanbul-Türkiye.
Department of Anesthesia and Reanimation, İstanbul Yeni Yüzyıl University, Gaziosmanpaşa Hospital, İstanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2022 Nov;28(11):1655-1658. doi: 10.14744/tjtes.2021.02065.
The pulmonary symptoms secondary to severe acute respiratory syndrome in coronavirus (COVID-19) infections are the most common presentation for the disease; however, it is now known that in a small portion of patients, severe hemorrhagic complications can also be seen. In this report, three cases of elderly women with known COVID-19 infection, developing spontaneous rectus sheath hematoma on anticoagulation therapy, are presented. Three cases presented above emphasize the need to perform a computed tomography examination after a sudden hemodynamic deterioration and a decrease in hemoglobin count in COVID-19 patients in intensive care units (ICUs). Since this clinical deterioration can be caused by spontaneous rectus sheath hematomas (RSH), it must be taken into consideration while examination. If these RSHs rupture into the abdominal cavity, the outcome may be fatal in few hours as represented in two of our cases. Major spontaneous hemorrhage in COVID-19 patients is quite uncommon; therefore, it may cause serious complications as it is rarely taken into consideration. Failure to acknowledge such a risk could significantly worsen the prognosis of the patients especially in ERs and ICUs.
继发于严重急性呼吸综合征冠状病毒（COVID-19）感染的肺部症状是该疾病最常见的表现；然而，现在已知在一小部分患者中，也可能出现严重的出血并发症。在本报告中，介绍了 3 例已知 COVID-19 感染的老年女性患者，她们在抗凝治疗时发生自发性腹直肌鞘血肿。以上 3 例强调了在 ICU 中 COVID-19 患者出现突然血流动力学恶化和血红蛋白计数下降时需要进行 CT 检查。由于这种临床恶化可能是由自发性腹直肌鞘血肿（RSH）引起的，因此在检查时必须考虑到这一点。如果这些 RSH 破裂进入腹腔，就像我们的两个病例那样，可能在数小时内导致致命后果。COVID-19 患者的自发性大出血相当罕见；因此，由于很少考虑到这种风险，它可能会导致严重的并发症。如果不承认这种风险，可能会显著恶化患者的预后，尤其是在急诊科和 ICU 中。
