Journal of medical case reports
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Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. ⋯ Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management.
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Herpes simplex infection is most commonly a benign, self-limiting disease with mucocutaneous lesions and mild viremia. Immunosuppressed patients are at a higher risk of disseminated infection, as are neonates and pregnant women. The incidence of fulminant herpes simplex virus hepatitis is extremely low, and the diagnosis is often missed due to the lack of specific signs or symptoms. ⋯ Despite aggressive medical therapy, fulminant herpes simplex virus hepatitis is fatal in the majority of patients. We present a review of the literature, which shows that immunocompetent adults have rarely been affected by fulminant herpes simplex virus hepatitis. Initiation of empirical therapy is warranted in patients with progressive hepatic failure with no other underlying cause. Acyclovir therapy has proven effective in some patients, but is less effective in patients who present in advanced stages of infection.