Symptomatic Postoperative Rectus Sheath Haematomas

ABSTRACT

We retrospectively reviewed six cases of post-operative rectus sheath haematoma (RSH) managed at our institute during last six years. Out of 6 patients (mean age 27 years) who presented with RSH, four preceded caesarean section and two abdominal hysterectomy. They presented clinically as pain abdomen (n-6), shock (n-3), DIC (n-2) and fever (n-1). Haemoperitoneum was observed in 3 patients with shock and the diagnosis was confirmed at surgery. Three clinically stable patients with an infraumbilical abdominal mass were managed conservatively. One required US guided aspiration of the infected haematoma. Massive RSH is an unusual potentially life threatening condition. The diagnosis should be considered in all patients with acute post-operative pain and free fluid in the abdomen.