3.7.2\ Differential Diagnosis

The acute clinical onset in a patient under anticoagulation supports the diagnosis of a rectus sheath hematoma. MR imaging may be useful in differentiation of chronic rectus sheath hematomas from anterior abdominal wall masses such as lipoma, hemangioma, neurofibroma, desmoid tumor, soft-tissue sarcoma, lymphoma, or metastatic lesions. Although bleeding into neoplasm may occur, hyperintense regions are rarely observed in tumors (Fukuda et al. 1996).

3.7.3\ Value of Imaging

In the presence of a clinically suspected rectus sheath hematoma or equivocal findings in sonography, CT should be performed. CT usually allows the correct diagnosis and obviates unnecessary surgical interventions (Berna et al. 1996).

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