Rectus Sheath Hematomas - TAddona

Rectus Sheath Hematomas - TAddona - Rectus Sheath Hematoma...

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Rectus Sheath Hematoma
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Dx: Rectus sheath hematoma
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Rectus Sheath Hematomas First case reported in US by Richardson in 1857 1999 Klinger found incidence of 1.8% in 1257 pts admitted to hospital w/ abd pain who had an abdominal U/S Richardson SB: Rupture of the right rectus abdominis muscle from muscular efforts: operation and recovery, with remarks. Am J Med Sci 1857; 33: 41-5 Klingler PJ, Wetscher G, Glaser K, et al: The use of ultrasound to differentiate rectus sheath hematoma from other acute abdominal disorders. Surg Endosc 1999 Nov; 13(11): 1129-34
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Arcuate line ~ 5cm below umbilicus; Below arcuate line only transversalis fascia and peritoneum
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Pathophysiology Rupture of one of the epigastric vessels -which run posteriorly on recti Rectus tear w/ shearing of sm vessel Causes: trauma, surgery, strenuated exercise or repeated valsalva (coughing/striaining for stool)
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Risk Factors Anticoagulation Surgery Trauma Coughing Pregnancy (labor/postpartum) Medical conditions – Leukemia, blood dyscrasias etc
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Presentation non-specific Dx is in the history & high level of suspicion
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Rectus Sheath Hematomas - TAddona - Rectus Sheath Hematoma...

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