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While on plasmapheresis and haemodialysis for delayed graft function, she developed acute left lower abdominal pain on the 16th postoperative day with tender swelling in the left paraumbilical region. CT of the abdomen showed a large haematoma in the left rectus sheath with no extension. The patient underwent haematoma evacuation through a left paramedian incision and had an uneventful recovery. Serum creatinine stabilised at 0.8\u2005mg\/dL and she is on regular follow-up with excellent graft function at 6\u2005months. Diagnosis requires a high index of suspicion, and prompt treatment prevents morbidity and can expedite patient recovery.<\/jats:p>","DOI":"10.1136\/bcr-2015-214144","type":"journal-article","created":{"date-parts":[[2016,2,4]],"date-time":"2016-02-04T09:42:30Z","timestamp":1454578950000},"page":"bcr2015214144","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Spontaneous rectus sheath haematoma in a deceased donor renal transplant recipient: a rare complication"],"prefix":"10.1136","volume":"2016","author":[{"given":"Jayaram","family":"Sreenivas","sequence":"first","affiliation":[{"name":"Department of Urology, Institute of Nephro Urology, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vilvapathy Senguttuvan","family":"Karthikeyan","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Nephro Urology, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathee","family":"SampathKumar","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Nephro Urology, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingaraju","family":"Umesha","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Institute of Nephro Urology, Bangalore, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,2,4]]},"reference":[{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.1","first-page":"91","article-title":"Spontaneous rectus sheath haematoma in a renal transplant","volume":"8","author":"Nikolina","year":"2010","journal-title":"BANTAO J"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.2","first-page":"164245","article-title":"An uncommon presentation of spontaneous rectus sheath hematoma with acute kidney injury due to obstructive uropathy and prerenal azotemia","volume":"2014","author":"Paschou","year":"2014","journal-title":"Case Rep Emerg Med"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.3","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000216818.13067.5a"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.4","first-page":"559","article-title":"Hematoma of the anterior rectus abdominis muscle as the first manifestation of lymphoproliferative disease after renal transplantation","volume":"20","author":"Franco","year":"2000","journal-title":"Nefrologia"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.5","doi-asserted-by":"publisher","DOI":"10.5812\/numonthly.9577"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(99)70172-1"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.7","first-page":"630","article-title":"Rectus sheath hematomas: their pathogenesis, diagnosis, and management","volume":"54","author":"Zainea","year":"1988","journal-title":"Am Surg"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.8","doi-asserted-by":"publisher","DOI":"10.1308\/003588407X179152"},{"key":"2025082704113854000_2016.feb04_1.bcr2015214144.9","doi-asserted-by":"crossref","unstructured":"Bern\u00e1 JD , Garcia-Medina V , Guirao J , et al . 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