Hematoma- very large abdominal

I am nearly 4 weeks post op and I am terrified. I developed a rare type of hematoma. It is called rectus sheeth. It is huge and spans across my lower abdomen about 6 inches long and 1 inch wide. It is very painful and uncomfortable. I received a transfusion in the hospital. I am no longer anemic, but it is painful to urinate, have a bowel movement, sleep on my side, and pressure when on my back, I have lower and upper back pain, pain meds only take the edge off, never take the pain away completely. They chose not to drain it in the hospital due to risk of infection, but my primary saw me and is shocked they did not drain it due to its size. This is not a hematoma associated at the incision sight, which I mostly read about here. It deep within muscle and tissue wall. Does or did anyone have this type of hematoma, have one of this size absorb or have one drained? I am looking for advice and a possible time frame for recovery, I go back to work as a teacher in 3 weeks. Help!

I had Laparoscopic Burch bladder repair (all stitches, no mesh) with robot assist on 11/30/2012. Two days later I hemorrhaged and needed 2 transfusions. I was left with a grapefruit size hematoma sitting on top my bladder and was completely incontinent.

Doctor said hematoma would dissolve on its own but two months later CT showed it only shrank 2 cm for the original 10 X 11 X 10. Feb 1 they inserted a drain directly into the hematoma and injected TPA (clot buster) med into it. There's a plastic thing taped just above the pubic bone (yes in the hair, they didn't shave me) followed by tubing, a valve, more tubing down to my knee, and a plastic jug the size of the kid's Little Hug juice drink. After 4 hours I opened the drain. Very little is draining, only about 5 cc per day. They were hoping for 300 cc.

I am still incontinent and, like you, looking for others who are dealing with post-op hematoma. My last resort is to have it surgically removed, but that comes with substantial risks, too. I'm scared and afraid this blood clot sitting atop my bladder will cause nerve damage to the bladder, thus it will never work right. That would leave me in much worse condition than before surgery.

But, most important is that I wanted to let you know you're not alone. I was supposed to go back to work Jan 7 but now have no idea when I'll go back.

Thank you for making me feel not alone! But I am also very sorry to hear your story because it sounds like a nightmare! They also told me mine would shrink, but it has not at all. I would rather take care of it sooner rather than later, but I am afraid I will be presented with the impossible decision to wait it out, or have it coagulate more. There is really very little information about these internal hematomas on the internet, and some have me reading that they drain them with only local anesthetic. I think I might faint if they try that.
I see a new surgeon tomorrow and I am hoping to get this gone and healing ASAP.My hysterectomy would have seemed like a breeze had this not happened
Please update with your progress.

The procedure I just had was precutaneous drain placement using CT scan guidance. For me, they waited too long and the hematoma is not draining. But this is an alternative to general anesthia surgery. You're awake for the placement of the catheter (drain), but the only pain is the sting of the numbing agent they inject the area with. They also give you IV pain and anxiety med as soon as the numbing (lidocaine) is injected. It's all really fast.

I just got off the phone with my surgeon since my clot is now too old and thick to drain. I need general anesthesia surgery to have a Caesarian insison made and then they'll scoop out the still grapefruit size clot.

I was reluctant to have the same surgeon, but not because of the clot issue or the current incontinence. When I awoke from the bladder surgery, in recovery I was screaming in agony. I screamed to God to let me die; pain was more than I could bear. My daughter was there and I truly regret she heard it or had to helplessly witness her mother in such pain.

So, the surgeon told me she would take additional steps for extra pain management so I did not come out of anesthesia in excruciating pain. Last time, they gave me morphine, but this time they intend to continually numb the area for a while after waking from anesthesia. Based on that, I will probably have the surgery and be out of work yet another 6-8 weeks.

Since your hematoma may still be liquid, that catheter drainage method may be the ideal thing for you without having to go through the risks of another surgery. It may work for you rather than waiting 6-8 months for the hematoma to be reabsorbed by your body.

Best wishes to you. I hope things work out well. Keep me posted, God bless us both.

I just saw the surgeon today. he said hematoma is solid and I would need to be re-opened and have it scraped out. like you mentioned He recommended for me not to have this done, and I am in agreement after hearing that the location of it between muscle tissue could cause additional bleeds. I will just need to wait it out and it could take months to a year to dissolve. i was hoping it could be aspirated. The pain from it is annoying and uncomfortable, yet, not excruciating. The worst part is staying comfortable at night, and I can stay active, yet not work any abdominal muscles for a loong time.

Good luck with your additional surgery, I hope that you are able to manage the pain and you get through it without any additional complications.

I know all of this can be hard on the kids, I have 2 teenage girls myself. They hate seeing mom in pain

Good luck and God Bless!

Thank you for the good wishes. I see my surgeon Wednesday and hope to schedule my surgery to remove the hematoma.

I'm so sorry they could not use the procedure I had done to try to drain yours. But, based on the location, I would agree it's not a good idea to surgically remove one embedded in muscle. Aside from risks mentioned, cutting of muscle is extremely painful and a long recovery.

It's been a pleasure talking with you, and I'll be sure to check back to see if you post an update. I wish you all the best and have added you to my prayers.

For me, focusing on the multiple blessings I've received, like my daughter, helps me get through this. Sounds like it's the same for you. May God bless us and keep us and our families safe.

Just wanted to update on haematoma removal surgery. It's a little over 2 weeks since surgery and I'm doing well. I've gained some control over the incontinence and am feeling much better about everything. I'm still having frequency problems, but it's not as bad as when the blood clot was there.

Running to the bathroom has decreased from > 30 Xs a day to about 20 Xs. I'm supposed to go to back to work March 21 but will have to wear protection, just in case. Work is different than home - the bathroom is far down a hallway, kiosk protected, and has double doors. Too bad I couldn't use the men's room - it's closer and within the secure area of our office (no kiosk to punch number code)! LOL

Back to the serious side: You're in my thoughts, and I pray you receive complete healing. It takes a long time for the haematoma to be absorbed. All I can suggest is that you take advantage of this time off.

I read an inspiration daily reading. Today's was about a woman who led a busy working life. She had a health issue that forced her into 7 months of treatment followed by recovery in partial isolation. She named this time "forced leisure." She says she learned how to slow down, reflect quietly, and rest in God's goodness, love, and perfect plan - regardless of whether or not she would be healed. She is now in remission and back to her busy life. However, she now often pauses to recapture the lessons of "forced leisure."

May God bless you and your family - and may He give you complete healing.