Andreassen K H, Olesen T E, Jacobsen P T
Kirurgisk afdeling K, Bispebjerg Hospital, København.
Ugeskr Laeger. 1996 Apr 15;158(16):2254-7.
Five cases of spontaneous rectus sheath haematomas observed during one year are reported. The female to male ratio was four to one. The age range was 26-75 years. Precipitating factors were cough in three patients, physical exercise in one patient, and none in one patient. In three cases there were possible predisposing factors: anticoagulant therapy, Addison's disease with steroid treatment and abdominal scar. The localisations were three lower right quadrant, one lower left and one upper right. In three cases correct diagnoses were made based on clinical findings, confirmed by ultrasonography and treated conservatively. In two cases the diagnosis was not suspected clinically, and by ultrasonography the haematoma was overlooked in one case, and misinterpreted as an intraperitoneal tumour in the other; both cases underwent surgery. The incidence rate was estimated to 3.5 per 100,000 per year. The frequency was approximately 0.9% in patients admitted with "acute abdomen".
本文报告了一年内观察到的5例自发性腹直肌鞘血肿。男女比例为4:1。年龄范围为26至75岁。诱发因素方面，3例患者为咳嗽，1例为体育锻炼，1例无明显诱因。3例存在可能的易感因素：抗凝治疗、接受类固醇治疗的艾迪生病和腹部瘢痕。血肿部位为右下象限3例、左下象限1例、右上象限1例。3例根据临床表现做出正确诊断，经超声检查确认后进行保守治疗。2例临床未怀疑诊断，其中1例超声检查漏诊了血肿，另1例则误诊为腹腔内肿瘤；这2例均接受了手术治疗。发病率估计为每年每10万人中3.5例。在因“急腹症”入院的患者中，其发生率约为0.9%。
