Rectus Sheath Hematoma, a Rare Complication of Asthma: A Case Report

氣喘併發腹直肌血腫：病例報告

蘇經凱(Chin-Kai Su) ； 王鴻昌(Hong-Chung Wang) ； 林旻希(Min-Hsi Lin) ； 盧朝勇(Jau-Yeong Lu)

《胸腔醫學》 18卷5期 (2003/10) Pp. 437-441

https://doi.org/10.29806/TM.200310.0008

摘要

腹直肌血腫是氣喘病的一種罕見的併發症。我們報告一老年男性因氣喘發作而嚴重咳嗽導致腹直肌血腫之病例。一名年齡六十五歲之病人患有間歇性呼吸困難及夜間咳嗽，被診斷有氣喘病八年，在外院接受氣管擴張劑與類固醇之治療。在住院前五日，氣喘發作時併有嚴重咳嗽而住院接受治療，兩天後因急性腹痛而轉至本院。理學檢查發現腹部有一10×12公分大之紫斑。我們安排腹部電腦斷層檢查，結果發現在施打顯影劑後，左側腹直肌有顯影情形，與腹直肌血腫相符。我們亦利用超音波導引在腹部病灶處抽出少量血塊，這更進一步幫我們確定診斷。之後病患接受止咳藥物、氣管擴張劑與類固醇以及在腹部病灶給予熱敷等內科治療，病患氣喘狀況改善且腹部病灶縮小，兩週後病患出院。

關鍵字

氣喘病 ； 腹直肌血腫

並列摘要

Hematoma of the rectus sheath is a rare complication of asthma. We describe a case of rectus sheath hematoma caused by severe coughing during an exacerbation of asthma. This 65-year-old male patient had been a victim of asthma for more than 8 years. He suffered an acute attack of asthma and was treated at a local hospital five days before this admission. Two days later, a sudden onset of severe cough followed by abdominal pain occurred. The physical examination found an ecchymosis measuring 10x12 cm in size at the periumbilical area of the abdomen. Computed tomography of the abdomen revealed a well-defined soft tissue mass with contrast media enhancement in the left rectus sheath, consistent with rectus sheath hematoma. The aspirate from an ultrasound-guided diagnostic tapping also showed the blood clot. The patient received bronchodilators, corticosteroids, antitussive agents, and local heat packing for this abdominal wall lesion. The clinical condition of the patient improved gradually and he was discharged 2 weeks after admission. Failure to suspect the presence of a rectus sheath hematoma as a cause of acute abdominal pain may result in unnecessary invasive diagnostic studies or laparotomy.

並列關鍵字

asthma ； rectus sheath hematoma