Diagnosis and treatment of medically treated rectus sheath hematoma caused by stabbing

Rectus sheath hematoma (RSH) mainly occurs due to anticoagulant therapy, and blunt traumas may also rarely cause RSH. However, there is no case report published on the follow-up and treatment process of RSH after stabbing. A 60-year-old man was admitted after stabbing himself for suicide. The patient had a history of using clopidogrel and oral antidiabetic drugs. On physical examination, there were many entrance holes (more than 10) in the anterior abdominal wall, the largest of which was in the periumbilical region, approximately 30 mm in size and reaching toward the intra-abdominal cavity. On computed tomography, there was a RSH of roughly 95 mm × 55 mm and a wound about 25 mm in diameter on the lateral side of the umbilicus, including hyperdense areas thought to belong to active extravasation. Due to a hemoglobin level decrease, hypotension, and tachycardia, he underwent an emergency laparotomy. On exploration, there was no need to intervene in the RSH. The patient was discharged without complications on the 7th postoperative day.