Biomaterial Database

Rupture of internal iliac artery aneurysm presenting as rectus sheath hematoma: case report. 2004

Gianmarco de Donato, and Eugenio Neri, and Irene Baldi, and Carlo Setacci

Vascular Surgery, University of Siena, Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy. gdedonato@inwind.it

This report describes a ruptured internal iliac artery aneurysm that presented as a rectus sheath hematoma (RSH). The patient developed abdominal pain and a large, tense lower abdominal wall mass without peritoneal signs. Computed tomography scan demonstrated a massive RSH contiguous with a ruptured left internal iliac artery aneurysm. Hypovolemic shock prompted immediate laparotomy, aneurysmorrhaphy of the ruptured aneurysm, and evacuation of the rectus hematoma. This uncommon presentation of internal iliac aneurysm rupture should caution against a simple diagnosis of "spontaneous" RSH in a patient with a potentially ruptured iliac aneurysm.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D009135	Muscular Diseases	Acquired, familial, and congenital disorders of SKELETAL MUSCLE and SMOOTH MUSCLE.	Muscle Disorders,Myopathies,Myopathic Conditions,Muscle Disorder,Muscular Disease,Myopathic Condition,Myopathy
D006406	Hematoma	A collection of blood outside the BLOOD VESSELS. Hematoma can be localized in an organ, space, or tissue.	Hematomas
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D017542	Aneurysm, Ruptured	The tearing or bursting of the weakened wall of the aneurysmal sac, usually heralded by sudden worsening pain. The great danger of a ruptured aneurysm is the large amount of blood spilling into the surrounding tissues and cavities, causing HEMORRHAGIC SHOCK.	Ruptured Aneurysm,Aneurysms, Ruptured,Ruptured Aneurysms
D017543	Iliac Aneurysm	Abnormal balloon- or sac-like dilatation in the wall of any one of the iliac arteries including the common, the internal, or the external ILIAC ARTERY.	Aneurysm, Iliac,Aneurysms, Iliac,Iliac Aneurysms
D017568	Rectus Abdominis	A long flat muscle that extends along the whole length of both sides of the abdomen. It flexes the vertebral column, particularly the lumbar portion; it also tenses the anterior abdominal wall and assists in compressing the abdominal contents. It is frequently the site of hematomas. In PLASTIC SURGERY PROCEDURES it is often used for the creation of MYOCUTANEOUS FLAP. (From Gray's Anatomy, 30th American ed, p491)	Rectus Abdominus,Recti Abdominis,Rectus Muscle of Abdomen,Abdomen Rectus Muscle,Abdomen Rectus Muscles,Abdominus, Rectus