Rectus Sheath Haematoma
This condition needs to be differentiated from Acute Appendicitis, Rectus sheath rupture typically occurs following straining or coughing.
It is seen frequently in footballers, sprinters, pregnant women, elderly women and muscular men.
They are likely to give a history of pain and swelling following an exertion or sudden burst of activity.
The inferior epigastric artery, one of the blood vessles from the groin that moves up to the abdomen is what is damaged.
This causes blood to track under the muscle covering, forming a mass with considerable pain. The swelling that results from the rectus sheath haematoma may be confused with an appendix mass.
It presents with sudden onset pain characteristically. Differentiating it from appendicitis, is the fact that patient will have no other symptom apart from the pain and mass.
No anorexia, nausea or vomiting. Patient may be taking oral anticoagulants (Blood thinning medication).
Bruising may be noticed on the flank of such patients.
It should be kept in mind as a cause of right iliac fossa pain and mass.
TREATMENT OF RECTUS SHEAT HAEMATOMA
If the haematoma is of considerable size, surgery may be necessary to evacuate it and tie the bleeding vessel.
Small haematoma can be treated without surgery.
The patients INR should be checked and controlled if he is using blood thinning medication.
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