Cough-induced rectus sheath hematoma in an adolescent without external abdominal findings: a case report.

Authors

Yujin Kaneko, Haruhisa Ozawa, Ayane Tachiki, Kensuke Sakamoto, Genki Takei, Yukiko Kouchi, Naoto Yoshida, Toyoaki Sawano, Tetsuya Tanimoto, Akihiko Ozaki, Hiroaki Shimmura

Published in

Journal of surgical case reports. Volume 2026. Issue 10. Pages rjag915. Epub Oct 14, 2026.

Abstract

Rectus sheath hematoma (RSH) is an uncommon cause of acute abdominal pain that predominantly affects older, anticoagulated adults and usually presents with a palpable abdominal-wall mass. We report a 17-year-old previously healthy male who developed midline lower abdominal pain after 6 days of severe coughing, without anticoagulation, trauma, or bleeding disorder, and with no visible swelling, ecchymosis, or palpable mass; Carnett's sign was positive. Ultrasonography, magnetic resonance imaging, and contrast-enhanced computed tomography confirmed a hematoma confined to the lower rectus sheath without active extravasation, and he recovered fully with conservative management. In a review of recent cough-induced RSH reports, all prior patients had a predisposing condition or external abdominal findings; our patient is the youngest reported and had neither. RSH should be considered in adolescents with persistent abdominal pain after severe coughing, even when examination is unremarkable.

PMID:
42877942
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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