Rectus sheath hematoma: diagnosis by computed tomography scanning.
Rectus sheath hematoma: diagnosis by computed tomography scanning.
复制标题
直肌鞘血肿：通过计算机断层扫描诊断。
作者：
Gocke Je;MacCarty Rl;Foulk Wt
一名65岁的妇女接受长期口服抗凝剂治疗的迹象和症状表明，结肠梗阻。触痛、坚实的左下腹肿块、结肠和小肠扩张、轻度白细胞增多和凝血酶原时间明显升高是突出的表现异常。急诊结肠X线检查未显示结肠梗阻，腹部超声最初未诊断。计算机断层扫描显示左侧腹直肌鞘和肌肉中有一个大肿块，在这种临床情况下，与自发性腹直肌鞘血肿一致。本报告的目的是提出计算机断层扫描在评估不确定的腹部肿块，如腹直肌鞘血肿的有用性。腹直肌鞘血肿的主题进行审查，强调其列入鉴别诊断的急腹症，并建议一个更早，更准确，无创的方法来诊断。
A 65-year-old woman receiving long-term oral anticoagulant therapy was admitted with signs and symptoms suggesting colonic obstruction. A tender, firm left lower-quadrant mass, colonic and small bowel distention, mild leukocytosis, and a markedly elevated prothrombin time were the prominent presenting abnormalities. Emergency colon x-ray study did not demonstrate colonic obstruction, and ultrasound of the abdomen was initially nondiagnostic. Computed tomography scanning revealed a large mass localized in the left rectus sheath and muscle consistent, in this clinical setting, with a spontaneous rectus sheath hematoma. The purpose of this report is to suggest the usefulness of computed tomography scanning in the evaluation of indeterminate abdominal masses such as the rectus sheath hematoma. The subject of rectus sheath hematoma is reviewed to emphasize its inclusion in the differential diagnosis of the acute abdomen and to suggest an earlier, more accurate, and noninvasive approach to its diagnosis.