Rectus sheath hematoma in post-lower segment caesarean section patient


  • Sunaina Kamboj Department of General Surgery, P. G. I. M. S, Rohtak, Haryana, India
  • Naresh Pal Department of General Surgery, P. G. I. M. S, Rohtak, Haryana, India
  • Bhavinder Kumar Arora Department of General Surgery, P. G. I. M. S, Rohtak, Haryana, India



Rectus sheath hematoma, Inferior epigastric artery, Lower segment caesarean section


Rectus sheath hematoma is a rather uncommon and often misdiagnosed clinical condition, usually follows abdominal trauma and anticoagulation. The daily activities of patient like sitting and lying in the bed produced the trauma which led to formation of hematoma. This trauma led to tear of inferior epigastric artery, which started bleeding with in the rectus sheath leading to formation of a big hematoma. Exploratory laparotomy was done. A hematoma of size 5×6 cm was visualized between anterior rectus sheath and rectus muscle on right side. Rectus muscle hematoma is due to shearing force to the inferior epigastric vessels due to routine activity of the patient.


Allen M, Sevensma KE. Rectus sheath hematoma. Treasure Island: StatPearls Publishing; 2023.

Cherry WB, Mueller PS. Rectus sheath hematoma: review of 126 cases at a single institution. Medicine. 2006;85(2):105-10.

Hatjipetrou A, Anyfantakis D, Kastanakis M. Rectus sheath hematoma: a review of the literature. Int J Surg. 2015;13:267-71.

Ducatman BS, Ludwig J, Hurt RD. Fatal rectus sheath hematoma. JAMA. 1983;249(7):924-5.

Sobkin PR, Bloom AI, Wilson MW, LaBerge JM, Hastings GS, Sheth HS, et al. Massive abdominal wall hemorrhage from injury to the inferior epigastric artery: a retrospective review. J Vasc Interv Radiol. 2008;19(3):327-32.

Kaldas H, Smith RE. Evaluation of risk factors for rectus sheath hematoma. Clin Appl Thromb Hemost. 2016;22(3):292-6.

Drinnon K, Simpson SS, Puckett Y, Ronaghan CA, Richmond RE. Rectus sheath hematoma: A rare surgical emergency. Cureus. 2020;12(12).

Bello G, Blanco P. Giant rectus sheath hematoma. Ultrasound J. 2019;11(1):1-5.

Rimola J, Perendreu J, Falcó J, Fortuño JR, Massuet A, Branera J. Percutaneous arterial embolization in the management of rectus sheath hematoma. Am J Roentgenol. 2007;188(6):497-502.






Case Reports