Laparoscopic Management of Rectus Sheath Hematomas

Dina Chamsy, MD, Deirdre Lum, MD, Suketu Mansuria, MD

Center for Minimally Invasive Gynecologic Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA (all authors).


Introduction: Rectus sheath hematomas can result from shearing of rectus muscle fibers or injury to the inferior epigastric vessels, which is the most common vascular injury to occur at the time of laparoscopic surgery.

Case Description: We describe a case of a rectus sheath hematoma that was diagnosed 5 days after operative laparoscopy. We review the clinical presentation, diagnostic criteria, and therapeutic options of managing rectus sheath hematomas, and we describe the innovative use of laparoscopy for hematoma drainage after failed conservative management.

Discussion: Rectus sheath hematomas that fail conservative management can be effectively drained laparoscopically. This minimally invasive approach provides rapid symptom relief and patient recovery.

Key Words: Hematoma, Surgical instruments, Complication, Laparoscopy.

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