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Case Reports in Emergency Medicine
Volume 2014, Article ID 164245, 4 pages
Case Report

An Uncommon Presentation of Spontaneous Rectus Sheath Hematoma with Acute Kidney Injury due to Obstructive Uropathy and Prerenal Azotemia

1Department of Family Medicine, General Hospital of Pella, 58200 Edessa, Greece
2Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
3Department of General Surgery, General Hospital of Pella, 58200 Edessa, Greece
4Nephrological Department, General Hospital of Pella, 58200 Edessa, Greece

Received 26 May 2014; Accepted 29 June 2014; Published 13 July 2014

Academic Editor: Aristomenis K. Exadaktylos

Copyright © 2014 Eleni Paschou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Rectus Sheath Hematoma (RSH) represents an unusual entity which is characterized by acute abdominal pain and tender palpable abdominal mass usually, among elderly patients receiving anticoagulant therapy. We report the case of an 81-year-old woman admitted to our department due to acute abdominal pain and oligoanuria. The patient had recently been hospitalized due to acute myocardial infarction (AMI) and atrial fibrillation (AF) and received both anticoagulant and antiplatelet therapies. The radiological assessments revealed an extended Rectus Sheath Hematoma and bilateral hydronephrosis. Treatment of the hematoma required cessation of anticoagulants and antiplatelet agents, immobilization, blood and fresh frozen plasma transfusion, and administration of vasopressors. The patient recovered gradually and was discharged home fifteen (15) days later.