<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1137-6627</journal-id>
<journal-title><![CDATA[Anales del Sistema Sanitario de Navarra]]></journal-title>
<abbrev-journal-title><![CDATA[Anales Sis San Navarra]]></abbrev-journal-title>
<issn>1137-6627</issn>
<publisher>
<publisher-name><![CDATA[Gobierno de Navarra. Departamento de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1137-66272017000300361</article-id>
<article-id pub-id-type="doi">10.23938/assn.0044</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hematoma espontáneo de recto anterior del abdomen: experiencia en nuestro centro]]></article-title>
<article-title xml:lang="en"><![CDATA[Rectus sheath haematoma: experience in our center]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Povar]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lasala]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Povar]]></surname>
<given-names><![CDATA[B.J.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Miguel Servet  ]]></institution>
<addr-line><![CDATA[Zaragoza ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2017</year>
</pub-date>
<volume>40</volume>
<numero>3</numero>
<fpage>361</fpage>
<lpage>369</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1137-66272017000300361&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1137-66272017000300361&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1137-66272017000300361&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Fundamento. Describir las características clínicas de los pacientes diagnosticados de hematoma espontáneo de músculo recto abdominal (HEMR), los factores predisponentes y precipitantes y el manejo terapéutico.  Pacientes y métodos. Estudio descriptivo retrospectivo de 46 HEMR diagnosticados desde 2002 hasta 2016. Se analizan datos epidemiológicos, clínicos, pruebas diagnósticas y modalidad de tratamiento.  Resultados. La mediana de edad fue de 81 años, 61% mujeres. Los factores desencadenantes más frecuentes fueron la tos persistente y la inyección de heparina de bajo peso molecular. El 70% estaban anticoagulados, de ellos el 57% presentaba INR en rango supraterapéutico y en el 45% se suspendió la anticoagulación de manera definitiva tras el ingreso. El 41% presentaban insuficiencia renal crónica y la creatinina en el momento del diagnóstico fue superior a la basal (p&lt;0,001). El tratamiento fue conservador en la mayoría de casos; se realizó radiología intervencionista en tres pacientes (6,5%) y cirugía abierta en cuatro (8,7%). El tratamiento invasivo se aplicó a pacientes con hematomas de mayor tamaño y con mayores requerimientos transfusionales, y se asoció a una mayor estancia media (p&lt;0,001).  Conclusiones. El HEMR es más frecuente en pacientes ancianos, tratados con acenocumarol y en rango supraterapéutico y conlleva con frecuencia la suspensión definitiva del tratamiento anticoagulante. La insuficiencia renal aparece relacionada con la sobredosificación del tratamiento anticoagulante y con la producción del hematoma. El tamaño del HEMR y los requerimientos transfusionales son factores que parecen relacionados con mayor necesidad de tratamiento invasivo mediante embolización arterial o cirugía.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background. To describe the clinical characteristics of patients diagnosed with spontaneous abdominal rectus muscle hematoma (RSH), predisposing and precipitating factors, and therapeutic management.  Method. Retrospective descriptive study of 46 RSH diagnosed from 2002 to 2016. Epidemiological, clinical, diagnostic tests and treatment were analyzed.  Results. The median age of patients was 81 years, 61% were female. The most frequent triggers were persistent coughing and injection of low molecular weight heparin. Seventy percent were anticoagulated, of which 57% had INR in the supratherapeutic range, and in 45% anticoagulation was definitively discontinued after admission. Forty-one percent presented chronic renal failure; moreover, creatinine at the time of diagnosis was higher than baseline (p &lt;0.001). In most cases, treatment was conservative; interventional radiology was performed on three patients (6.5%) and open surgery on four (8.7%). Invasive treatment was employed with patients who had larger hematomas and higher transfusion requirements, and this was associated with a longer mean stay (p&lt;0.001).  Conclusions. RSH is more frequent in elderly patients, treated with acenocumarol and in the supratherapeutic range, and frequently entails permanent suspension of anticoagulant therapy. Renal insufficiency is related to the overdosage of the anticoagulant treatment and to the production of the hematoma. The size of RSH and transfusion requirements are factors that seem to be related to a greater need for invasive treatment through arterial embolization or surgery.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Hematoma espontáneo]]></kwd>
<kwd lng="es"><![CDATA[Vaina del recto]]></kwd>
<kwd lng="es"><![CDATA[Tratamiento anticoagulante]]></kwd>
<kwd lng="es"><![CDATA[Embolización arterial]]></kwd>
<kwd lng="es"><![CDATA[Dolor abdominal]]></kwd>
<kwd lng="en"><![CDATA[Spontaneous rectus sheath hematoma]]></kwd>
<kwd lng="en"><![CDATA[Abdominal wall disease]]></kwd>
<kwd lng="en"><![CDATA[Anticoagulant therapy]]></kwd>
<kwd lng="en"><![CDATA[Transcatheter embolization]]></kwd>
<kwd lng="en"><![CDATA[Abdominal pain]]></kwd>
</kwd-group>
</article-meta>
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