Spontaneous rectus sheath hematomas in dengue hemorrhagic fever: A case report

Nelwan, Erni Juwita; Angelina, Frida; Adiwinata, Randy; Matondang, Sahat; Andriono, Prasetyo

doi:10.1016/j.idcr.2017.08.004

Cited by 11 publications

(9 citation statements)

References 11 publications

(11 reference statements)

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“…SRSHs may be confused mostly with appendicitis, renal colic and abdominal hernia that can cause pain in the right lower abdominal quadrant as well as with gynecological diseases and other intra-abdominal pathologies such as diverticulitis, biliary diseases, pancreatitis, intestinal obstruction, colorectal diseases, abdominal tumors, and ruptured aortic aneurysm [1]. Although USG is used for initial examination due to easy access, fast application, and absence of radiation, contrast-enhanced CT is preferred as a primary diagnostic modality with 100% sensitivity and specificity in establishing a diagnosis, and it can even show active bleeding [14, 15]. CT also prevents unnecessary surgical interventions by excluding other intra-abdominal pathologies, provides information on the origin, extension, and nature of the hematoma, and helps in identification of the treatment option by classifying rectus sheath hematomas by their anatomic structures, sizes, and localizations.…”

Section: Discussionmentioning

confidence: 99%

Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

Karapolat

TAŞDELEN

Korkmaz

2019

Emergency Medicine International

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Introduction. Spontaneous rectus sheath hematoma (SRSH) is characterized by bleeding within the rectus abdominis muscle sheath, one of the rare causes of acute abdominal pain. Early diagnosis is imperative in SRSH to prevent complications and the treatment is usually conservative. We intended to present in this study our experience with SRSH patients with respect to diagnostic evaluation and management of their disease. Materials and Methods. In this retrospective study, 14 patients who had received treatment for SRSH in our clinic between January 2012 and December 2017 were assessed in terms of demographic and clinical characteristics, comorbidities, laboratory parameters, diagnostic approach methods, treatment practices, length of hospital stay, and patient outcomes. Results. The patients consisted of 10 (71.4%) females and 4 males (28.6%). The age of the patients ranged between 47 and 93 with a mean age of 66.5 ± 12.1. Anticoagulant treatments were being administered to 5 (35.7%) patients, antiplatelet treatments to 4 (28.5%) patients, and both anticoagulant and antiplatelet treatments to 4 (28.5%) patients. The most common triggering factor was severe cough and the most common initial symptom acute abdominal pain (71.4%). In physical examinations, the entire patients had generalized abdominal tenderness, 10 (71.4%) voluntary guarding and 7 (50%) a right lower quadrant mass. The diagnosis was confirmed by abdominal ultrasonography and computed tomography. Based on the computed tomography findings, the disease was classified as Type 2 found in 9 (64.3%) patients, Type 1 in 3 (21.4%) patients, and Type 3 in 2 (14.2%) patients. All the patients were treated conservatively. They were hospitalized for 1 to 23 days. There was no mortality. All the patients were followed up between 3 months and 2 years and no recurrence was recorded. Conclusion. Considering the presence of SRSH particularly in older female patients who use anticoagulant drugs and have newly developed an abdominal pain and a palpable mass after coughing spells is the key to make an early and correct diagnosis and to prevent possible morbidity and mortality with an appropriate treatment method.

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Section: Discussionmentioning

confidence: 99%

Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

Karapolat

TAŞDELEN

Korkmaz

2019

Emergency Medicine International

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“…Supplemental Table S5 summarizes the other less common surgical manifestations in dengue. 16,23,[95][96][97][98][99][100][101][102][103][104][105][106][107][108][109][110][111][112][113][114] Seven studies and several case reports/series were found mainly from Asian countries. A total of 296 patients were described.…”

Section: Common Causes Of Acute Abdomen In Dengue Infectionsmentioning

confidence: 99%

Dengue Infections and the Surgical Patient

Jayarajah

Lahiru

Zoysa

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Dengue infections are increasing globally and account for significant morbidity and mortality. Severe dengue results in microvascular changes and coagulopathy that may make surgical intervention risky and the overall surgical management challenging. We outline the potential surgical manifestations and complications following dengue infections and describe the clinical, pathogenetic, diagnostic, and treatment aspects of dengue and surgical patients. The main surgical presentations were acute cholecystitis, acute pancreatitis, acute appendicitis, splenic rupture, bowel perforation, gastrointestinal bleeding, and hematomas. Dengue may also mimic an acute abdomen without any true surgical complications. A majority were treated nonoperatively. Misdiagnosis and unnecessary surgical intervention resulted in poor outcomes. Better knowledge of the potential surgical complications would help in early diagnosis, treatment, and referral to specialized centers and thus improve outcomes. A high degree of suspicion of dengue fever is necessary when patients in a dengue-epidemic area present with acute abdomen or bleeding manifestations. In endemic areas, early dengue antigen testing and abdominal imaging before surgical intervention may help in the diagnoses. Multidisciplinary team involvement with case-by-case decision-making is needed for optimal care.

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“…[5][6][7] Among bleeding complications, muscles hematomas are rare and the common sites of intramuscular hematomas are rectus sheath, psoas and iliacus muscles. 8…”

Section: Discussionmentioning

confidence: 99%

Spontaneous muscle hematoma complicating dengue hemorrhagic fever: a case report

et al. 2019

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Dengue is endemic in Bangladesh and is an emerging infection in many parts of the world. Its clinical manifestations are wide spectrum, may present as mild fever to shock. Muscle hematomas are rare complications in dengue hemorrhagic fever. We report a case of 21-year-old male with dengue hemorrhagic fever who developed right sided iliacus muscle hematoma. He presented with fever, progressive thrombocytopenia and evidence of plasma leakage. During the recovery phase, he developed severe pain in right hip during movement. Diagnosis was confirmed by pelvic computed-tomography scan and he was managed conservatively.

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Spontaneous rectus sheath hematomas in dengue hemorrhagic fever: A case report

Cited by 11 publications

References 11 publications

Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single Center Experience and Literature Review

Dengue Infections and the Surgical Patient

Spontaneous muscle hematoma complicating dengue hemorrhagic fever: a case report

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