ArticleJournal of surgical case reports2026
Cough-induced rectus sheath hematoma in an adolescent without external abdominal findings: a case report.
Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Rectus sheath hematoma (RSH) is an uncommon cause of acute abdominal pain that predominantly affects older, anticoagulated adults and usually presents with a palpable abdominal-wall mass. We report a 17-year-old previously healthy male who developed midline lower abdominal pain after 6 days of severe coughing, without anticoagulation, trauma, or bleeding disorder, and with no visible swelling, ecchymosis, or palpable mass; Carnett's sign was positive. Ultrasonography, magnetic resonance imaging, and contrast-enhanced computed tomography confirmed a hematoma confined to the lower rectus sheath without active extravasation, and he recovered fully with conservative management. In a review of recent cough-induced RSH reports, all prior patients had a predisposing condition or external abdominal findings; our patient is the youngest reported and had neither. RSH should be considered in adolescents with persistent abdominal pain after severe coughing, even when examination is unremarkable.
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