Rectus Sheath Hematoma: A Simplified Emergency Surgical Approach

Michael Mantelas1, *, Niki Katsiki2, 3, Polychronis Antonitsis1, Ellada Kyurdzhieva4, Dimitri P Mikhailidis2, Apostolos Hatzitolios3
1 Department of Cardiothoracic Surgery, AHEPA University Hospital, Thessaloniki, Greece
2 Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, University College London (UCL), London NW3 2QG, UK
3 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
4 Department of Anesthesia, AHEPA University Hospital, Thessaloniki, Greece

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© Mantelas et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the AHEPA University Hospital St. Kiriakidi 1, 54636 Thessaloniki Greece; Tel: 00302310994843; Fax: 00302310994871; E-mail:


Rectus sheath hematoma (RSH) is an uncommon clinical event usually associated with trauma or coagulation disorders. It can also occur spontaneously. RSH usually runs a benign course but it can present with hypovolemic shock. When conservative management fails, surgical exploration becomes mandatory. We propose a technique of emergency ligation of the inferior epigastric artery. This is a simple approach as this artery originates at the posterior rectus sheath above the inguinal ligament. This safe technique provides immediate hemodynamic stabilization.

Keywords: Rectus sheath, hematoma, inferior epigastric artery..