Klausner J M, Lelcuk S, Hornstein E, Rozin R R
Harefuah. 1981 Feb 1;100(3):122-4.
Rectus sheath hematoma is rarely diagnosed preoperatively. It can mimic acute intra-abdominal disease and other familiar disorders. It is more frequent during pregnancy and debilitating diseases. Blunt trauma to the abdomen, straining, coughing and anticoagulant therapy are also common contributing factors. The presenting symptom is onset of acute, localized, abdominal pain soon after the precipitating event. A tender abdominal mass is palpated in one of the rectus muscles. There are no specific diagnostic laboratory tests. Ultrasonography is the procedure of choice for correct diagnosis. Most of these patients can be successfully managed conservatively. During a period of two years, five cases were treated. Three of the patients suffered from acute cough associated with upper respiratory infections. Two had had multiple childbirths, one had had an abdominal operation and another had Cushing's disease and morbid obesity. Three were misdiagnosed and operated on. The hematoma was evacuated but the peritoneum was not opened. In two patients the correct diagnosis was made by ultrasonography and they were successfully treated conservatively.
腹直肌鞘血肿术前很少被诊断出来。它可酷似急性腹腔内疾病及其他常见病症。在孕期和患有使人虚弱的疾病时更为常见。腹部钝性创伤、用力、咳嗽及抗凝治疗也是常见的促成因素。主要症状是在诱发事件后不久突发急性、局限性腹痛。在一块腹直肌中可触及压痛性腹部肿块。没有特异性的诊断性实验室检查。超声检查是正确诊断的首选方法。这些患者大多数可通过保守治疗成功处理。在两年期间，治疗了5例。其中3例患者患有与上呼吸道感染相关的急性咳嗽。2例有多次分娩史，1例做过腹部手术，另1例患有库欣病和病态肥胖症。3例被误诊并接受了手术。血肿被清除，但未打开腹膜。2例患者通过超声检查做出了正确诊断，并通过保守治疗成功治愈。
