ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Rectus sheath hematoma: conservative, endovascular or surgical treatment? A single-center artificial neural network analysis.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 8 citations in OpenAlex.
- Factors predicting need for intervention and mortality in patients with spontaneous rectus sheath hematoma.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Article
- Spontaneous Rectus Sheath Hematoma Presenting As Acute Abdomen in an Anticoagulated Patient: A Case Report.Cureus · 2026Article
- Urgent Rectus Sheath Hematoma Induced by Severe Coughing.JMA journal · 2026Article
- Rectus sheath hematoma masquerading as acute pancreatitis: a case report.Annals of medicine and surgery (2012) · 2026Article
- Out-of-hospital onset versus in-hospital onset for clinical outcomes in spontaneous intramuscular hematoma diagnosed by computed tomography: a retrospective cohort study.Internal and emergency medicine · 2025Article
- Spontaneous Abdominal Wall Hematoma Following Violent Cough: A Rare but Severe Condition-Surgical Challenges and Outcomes Regarding Three Cases and a Literature Review.Reports (MDPI) · 2025Article
- Acute obstructive uropathy secondary to a rectus sheath haematoma in an anticoagulated patient.Journal of surgical case reports · 2024Article
- Real-time evaluation of active bleeding severity in soft-tissue hematomas via contrast-enhanced ultrasound: a case series.Quantitative imaging in medicine and surgery · 2024Article
- Spontaneous Abdominal Wall Hematoma: Early Recurrence without an Anticoagulant in an Elderly Woman Receiving Chronic Corticosteroid Treatment.Internal medicine (Tokyo, Japan) · 2024Article
- The prominent role of percutaneous transarterial embolization in the treatment of anterior abdominal wall hematomas: the results of three high volume tertiary referral centers.La Radiologia medica · 2023Article
- Rectus Sheath Hematoma as a Complication in Patients With COVID-19: Clinical and Imaging Findings.Cureus · 2023Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRectum sheath hematoma (RSH) is a rare and often misdiagnosed disease. We aimed to determine outcomes of patients affected by RSH and identify variables associated with the need of prompt intervention.
methodsPatients diagnosed with RSH during the period 2012-2020 were retrospectively identified. Demographics, diagnostic, and therapeutic variables were evaluated. RSH was classified with computed tomography (CT) according to the Berna system. An artificial neural network (ANN) model including 12 variables was used to identify patients that might require a prompt endovascular or surgical treatment.
resultsA total of 20 patients were included for analysis; mean age was 69 (35-98) years and 14 (70%) were females. Iatrogenic injury and forceful contraction of the abdominal wall were the leading causes of RSH. Eleven (55%) patients were anticoagulated or antiaggregated. There were 3 (15%) grade 1, 5 (25%) grade 2, and 12 (60%) grade 3 RSH; 6 (30%) were treated conservatively, 10 (50%) with artery embolization, and 4 (20%) with surgery. Overall morbidity was 45% and there was no mortality in the series. According to the ANN, patients at high risk of requiring an invasive treatment were those with active extravasation on CT angiography, Berna grade III, age ≥ 65 years, hemodynamic instability, chronic use of corticosteroids, hematoma volume ≥ 1000 mL, and/or transfusion of ≥ 4 units of red blood cells.
conclusionConservative treatment might be effective in selected patients with RSH. Our artificial neural network analysis might help selecting patients who require endovascular or surgical treatment.
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