Diagnosis of Rectus Sheath Hematoma by Point-of-Care Ultrasound

Casey Carr, Randall Rhyne

Research output: Contribution to journalArticlepeer-review


Background: Rectus sheath hematoma is a rare but dangerous cause of undifferentiated hypotension and abdominal pain in the emergency department (ED). Point-of-care ultrasound is a useful tool in its identification. Case Report: A 75-year-old woman presented to the ED with hypotension of an unclear etiology. She was found, via point-of-care ultrasound, to have a large and expanding rectus sheath hematoma. She ultimately had embolization of a lacerated epigastric artery, likely caused by enoxaparin injection. Why Should an Emergency Physician Be Aware of This?: Rectus sheath hematomas are a dangerous and often unrecognized source of abdominal pain and shock in anticoagulated patients. Commonly applied point-of-care ultrasound algorithms to assess hypotension may miss this entity.

Original languageEnglish (US)
Pages (from-to)680-683
Number of pages4
JournalJournal of Emergency Medicine
Issue number6
StatePublished - Jun 2019


  • bedside ultrasound
  • point-of-care ultrasound
  • rectus sheath hematoma
  • undifferentiated hypotension

ASJC Scopus subject areas

  • Emergency Medicine


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