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Pathogenesis and Management of Abdominal Wall Hematomas

Pathogenesis and Management of Abdominal Wall Hematomas Abstract SUDDEN disruption of a deep epigastric vessel may result in an abdominal wall hematoma which, depending on its location and size, can produce symptoms and clinical findings compatible with a variety of acute intraabdominal conditions. Recognized by the physicians of antiquity, such hematomas are an example of an unusual, infrequently encountered clinical entity in which early accurate diagnosis can alleviate anxiety in an alarmed and often markedly uncomfortable patient. Unfortunately, the clinical manifestations of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed believing that intraabdominal pathology is present. In the past almost all case reports and collective reviews have enumerated sudden unexpected trauma, weakened or diseased musculature, and idiopathic etiology as the underlying causes of rectus muscle hematomas. The purpose of this report, which describes three etiologically different cases, is not only to review the history, anatomy, predisposing causes, diagnosis, and treatment of this interesting clinical entity, References 1. Richardson, S.B.: Rupture of the Right Rectus Abdominis Muscle From Muscular Efforts: Operation and Recovery, With Remarks , Amer J Med Sci 33:41, 1857.Crossref 2. Maydl, K.: Über subcutane Muskel and Sehnen-Zerreissungen sowie Rissfracturen , Deutsch Z Chir 17:306, 1882.Crossref 3. Pilcher, L.S.: Spontaneous Rupture of the Rectus Abdominis Muscle, Brooklyn and New York Year Book, Pilcher Hospital, 1913, vol 3, p 14. 4. Wohlgemuth, K.: Über die subcutane Ruptur des Musculus rectus abdominis und der Arteria epigastrica; spontane Bauchdeckenhematome , Arch Klin Chir 122:649, 1923. 5. Hilgenreiner, H.: Das spontane Bauchdeckenhematom des vorgerrückten Lebensalters; ein Beitrag zur Spontanruptur des Musculus rectus abdominis , Beitr Klin Chir 129:700, 1923. 6. Hobbs, F.B.: Fatal Hemorrhage Into Rectus Abdominis Muscle During Pregnancy , Brit Med J 1: 895, 1938.Crossref 7. Teske, J.M.: Hematoma of the Rectus Abdominis Muscle , Amer J Surg 71:689, 1946.Crossref 8. Fruin, R.L., and McLaughlin, C.W.: Rectus Muscle Strain Simulating Acute Intraperitoneal Disease , US Naval Med Bull 42:172, 1944. 9. Bowers, W.F., and Richard, N.F.: Rectus Muscle Strain Simulating Acute Appendicitis , Milit Surg 92:645, 1944. 10. Trafford, E.: Disruption of Rectus Abdominis With Hematoma Formation , Brit Med J 2:1130, 1951.Crossref 11. Aird, I.: Companion in Surgical Studies , Edinburgh and London: E. & S. Livingstone, Ltd., 1957. 12. Woodburne, R.T.: Essentials of Human Anatomy , London: Oxford University Press, 1957, pp 372-376. 13. Brodel, M.: Lesions of the Rectus Abdominis Muscle Simulating an Acute Intra-abdominal Condition , Bull Hopkins Hosp 61:205, 1937. 14. Virchow, R.: Ueber Entzündung und Ruptur des M. rectus abdominis , Verhandl Phys Med Gesell Wurzburg 7:213, 1857. 15. Zenker, F.A.: " Ueber die Veränderungen der willkürlichen Muskeln im Typhus abdominalis: I. Casuistik ", in Programm zum Eintritt in die medizinische Fakultät der Friedrich-Alexander-Universität zu Erlangen , Erlangen, Germany: A. E. Junge, 1863. 16. Cullen, T.S.: Hemorrhage into or Beneath the Rectus Muscle Simulating an Acute Abdominal Condition , Bull Hopkins Hosp 6:317, 1937. 17. Culbertson, C.: Hematoma Occurring Spontaneously in Sheath of Rectus Abdominis Muscle , JAMA 85:1955-1958 ( (Dec 19) ) 1925.Crossref 18. Fothergill, W.E.: Haematoma in the Abdominal Wall Simulating Pelvic New Growth , Brit Med J 1:941, 1926.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Pathogenesis and Management of Abdominal Wall Hematomas

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Publisher
American Medical Association
Copyright
Copyright © 1966 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1966.01330060073004
Publisher site
See Article on Publisher Site

Abstract

Abstract SUDDEN disruption of a deep epigastric vessel may result in an abdominal wall hematoma which, depending on its location and size, can produce symptoms and clinical findings compatible with a variety of acute intraabdominal conditions. Recognized by the physicians of antiquity, such hematomas are an example of an unusual, infrequently encountered clinical entity in which early accurate diagnosis can alleviate anxiety in an alarmed and often markedly uncomfortable patient. Unfortunately, the clinical manifestations of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed believing that intraabdominal pathology is present. In the past almost all case reports and collective reviews have enumerated sudden unexpected trauma, weakened or diseased musculature, and idiopathic etiology as the underlying causes of rectus muscle hematomas. The purpose of this report, which describes three etiologically different cases, is not only to review the history, anatomy, predisposing causes, diagnosis, and treatment of this interesting clinical entity, References 1. Richardson, S.B.: Rupture of the Right Rectus Abdominis Muscle From Muscular Efforts: Operation and Recovery, With Remarks , Amer J Med Sci 33:41, 1857.Crossref 2. Maydl, K.: Über subcutane Muskel and Sehnen-Zerreissungen sowie Rissfracturen , Deutsch Z Chir 17:306, 1882.Crossref 3. Pilcher, L.S.: Spontaneous Rupture of the Rectus Abdominis Muscle, Brooklyn and New York Year Book, Pilcher Hospital, 1913, vol 3, p 14. 4. Wohlgemuth, K.: Über die subcutane Ruptur des Musculus rectus abdominis und der Arteria epigastrica; spontane Bauchdeckenhematome , Arch Klin Chir 122:649, 1923. 5. Hilgenreiner, H.: Das spontane Bauchdeckenhematom des vorgerrückten Lebensalters; ein Beitrag zur Spontanruptur des Musculus rectus abdominis , Beitr Klin Chir 129:700, 1923. 6. Hobbs, F.B.: Fatal Hemorrhage Into Rectus Abdominis Muscle During Pregnancy , Brit Med J 1: 895, 1938.Crossref 7. Teske, J.M.: Hematoma of the Rectus Abdominis Muscle , Amer J Surg 71:689, 1946.Crossref 8. Fruin, R.L., and McLaughlin, C.W.: Rectus Muscle Strain Simulating Acute Intraperitoneal Disease , US Naval Med Bull 42:172, 1944. 9. Bowers, W.F., and Richard, N.F.: Rectus Muscle Strain Simulating Acute Appendicitis , Milit Surg 92:645, 1944. 10. Trafford, E.: Disruption of Rectus Abdominis With Hematoma Formation , Brit Med J 2:1130, 1951.Crossref 11. Aird, I.: Companion in Surgical Studies , Edinburgh and London: E. & S. Livingstone, Ltd., 1957. 12. Woodburne, R.T.: Essentials of Human Anatomy , London: Oxford University Press, 1957, pp 372-376. 13. Brodel, M.: Lesions of the Rectus Abdominis Muscle Simulating an Acute Intra-abdominal Condition , Bull Hopkins Hosp 61:205, 1937. 14. Virchow, R.: Ueber Entzündung und Ruptur des M. rectus abdominis , Verhandl Phys Med Gesell Wurzburg 7:213, 1857. 15. Zenker, F.A.: " Ueber die Veränderungen der willkürlichen Muskeln im Typhus abdominalis: I. Casuistik ", in Programm zum Eintritt in die medizinische Fakultät der Friedrich-Alexander-Universität zu Erlangen , Erlangen, Germany: A. E. Junge, 1863. 16. Cullen, T.S.: Hemorrhage into or Beneath the Rectus Muscle Simulating an Acute Abdominal Condition , Bull Hopkins Hosp 6:317, 1937. 17. Culbertson, C.: Hematoma Occurring Spontaneously in Sheath of Rectus Abdominis Muscle , JAMA 85:1955-1958 ( (Dec 19) ) 1925.Crossref 18. Fothergill, W.E.: Haematoma in the Abdominal Wall Simulating Pelvic New Growth , Brit Med J 1:941, 1926.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Dec 1, 1966

References