CT of muscular hematoma

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Author: Mikael Häggström [notes 1]

Rectus sheath hematoma



Main risk factors are:

  • Hypocoagulability, such as anticoagulant medication
  • Trauma

Choice of modality

IV contrast

For follow-up of a known muscular hematoma, it is sufficient to perform CT without IV contrast.[notes 2] If detection of contrast extravasation or active bleeding is specifically requested, an arterial phase contrast CT is preferred.[1]


  • Location
  • Size
  • If contrast CT, any visible contrast leakage


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
  2. A contrast CT can detect extravasation of contrast material, but this does not seem to be correlated to clinical severity, as evidenced from rectus sheath and iliopsoas hematomas.
    - Landecy, Marie; Paquette, Brice; Revel, Lucie; Behr, Julien; Badet, Nicolas; Delabrousse, Eric (2016). "Does IV contrast extravasation on CT in anticoagulant-related rectus sheath and iliopsoas hematoma predict hematoma expansion and patient outcomes? ". Abdominal Radiology 41 (11): 2241–2247. doi:10.1007/s00261-016-0818-4. ISSN 2366-004X.