Rectus Sheath Hematoma Complicated by Rectus Abdominus Myonecrosis in a Patient with Rheumatoid Arthritis

Hyung Ran Yun; Ki Deok Yoo; Yoon Jeong Kim; Tae-Seok Yoo; Soon-Young Song; Jae-Bum Jun

doi:10.4078/jkra.2007.14.1.91

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Yun, Yoo, Kim, Yoo, Song, and Jun: Rectus Sheath Hematoma Complicated by Rectus Abdominus Myonecrosis in a Patient with Rheumatoid Arthritis

Original Article

J Korean Rheum Assoc 2007;14(1):91-95.

Published online: 23 March 2007

DOI: https://doi.org/10.4078/jkra.2007.14.1.91

Rectus Sheath Hematoma Complicated by Rectus Abdominus Myonecrosis in a Patient with Rheumatoid Arthritis

Hyung Ran Yun, M D., Ki Deok Yoo, M.D.^∗, Yoon Jeong Kim, M.D.^∗∗, Tae-Seok Yoo, M.D., Soon-Young Song, M.D.^∗∗∗, Jae-Bum Jun, M.D.^∗∗

^∗YTS Rheumatology Clinic, Department of Internal Medicine, Hanyang University School of Medicine, Seoul, Korea

^∗∗Departement of Rheumatology, The Hospital for Rheumatic Diseases, Seoul, Korea

^∗∗∗Department of Radiology, Hanyang University School of Medicine, Seoul, Korea

Received 3 January 200715 January 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rectus sheath hematoma is an uncommon cause of acute abdomen, caused by a tear in deep epigastric vessels or its branches. It occurs spontaneously, after trauma or surgery. Rectus abdominus myonecrosis is a life threatening complication of rectus sheath hematoma. We report a case with fatal rectus sheath hematoma complicated by rectus abdominus myonecrosis caused by ischial fracture in a chronic active rheumatoid arthritis patient.

Keywords: Rectus sheath hematoma, Myonecrosis, Rheumatoid arthritis, Fracture

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Fig. 1.

Pelvis AP showing severe osteoporosis with fracture line in the left inferior pubic ramus.

Fig. 2.

(A) Pelvis computed tomography scan shows fracture and dislocation in left inferior pubic ramus with hematoma. (B) Pelvis computed tomography scan shows upward extension of a mass with inhomogenous density in rectus sheath.

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