PMC5576157_01
Active arterial haemorrhage into the rectus sheath. Axial computed tomography of the pelvis with contrast shows active arterial haemorrhage into right rectus sheath (white arrowhead) and large haematoma with layering of blood in the pelvis (black arrow).
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CT abdomen/pelvis with contrast showed right rectus abdominis haematoma below the level of the umbilicus with active arterial bleeding in the extraperitoneal pelvis causing mass compression (Figure 1, Figure 2, Figure 3).
Large rectus sheath haematoma extending into pelvis and compressing the bladder. Sagittal computed tomography abdomen and pelvis shows the haematoma extending into the extraperitoneal pelvis causing displacement and obscuration of the bladder due to the size of the haematoma. Notice the active arterial haemorrhage (white arrowhead).
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CT abdomen/pelvis with contrast showed right rectus abdominis haematoma below the level of the umbilicus with active arterial bleeding in the extraperitoneal pelvis causing mass compression (Figure 1, Figure 2, Figure 3).
Hydronephrosis. Renal ultrasound shows right hydronephrosis.
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CT abdomen/pelvis with contrast showed right rectus abdominis haematoma below the level of the umbilicus with active arterial bleeding in the extraperitoneal pelvis causing mass compression (Figure 1, Figure 2, Figure 3). Renal ultrasound showed right hydronephrosis (Fig. 3).
Embolisation of right inferior epigastric artery. Coaxial microcatheter into the right inferior epigastric artery shows proximal embolisation with several microcoils.
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Embolisation of the RIEA was performed with 0.018 inch tornado microcoils (Fig. 4).
Intra-operative evacuation of haematoma. Intra-operative picture showing rectus sheath haematoma visible through the rectus sheath.
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The haematoma was confirmed to be a rectus sheath haematoma by palpation and indirect visualisation through the rectus sheath (Fig. 5).
Resolution of hydronephrosis. Post-operative right renal ultrasound shows interval resolution of hydronephrosis.
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The sCrea level normalised to 0.99 mg/dl, and post-operative renal ultrasound showed resolution of hydronephrosis (Fig. 6).