• Robert A Dineen, Nina R Lewis, and Nishath Altaf.
• Department of Academic Radiology, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom.
• Med. Sci. Monit. 2005 Oct 1; 11 (10): CS57-9.

BackgroundA rectus sheath haematoma is a difficult condition to diagnose and is usually treated by conservative measures. However, significant sized haematomas can result in severe haemodynamic repercussions, especially in those patients with co-morbidities and anticoagulation.Case ReportThe case reported here is of a 68 year old anticoagulated patient with severe medical co-morbidity who presented with abdominal pain and hypotension. An abdominal CT scan demonstrated a large rectus sheath haematoma and small bowel infarction. The relationship between these two separate causes of an acute abdomen is discussed and imaging findings are illustrated.ConclusionsA careful history and a high index of suspicion are necessary to diagnose a rectus sheath haematoma. Further imaging such as CT may be required and if diagnosed early enough, it should be treated aggressively based on the clinical findings.

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