[A Case of Rectus Sheath Hematoma Presenting Immediately after a Lumboperitoneal Shunt and Requiring Emergency Surgery:Importance of Abdominal Anatomy Knowledge].

As the incidence of idiopathic normal-pressure hydrocephalus (iNPH) rises in an aging society, the number of cerebrospinal fluid (CSF) shunts performed increases every year. The morbidity of iNPH in patients>65 years of age has been reported as 1.4%-2.9% in Japan. CSF shunts are rarely associated with mortality and are generally safe to perform, but subcutaneous hematomas and intestinal injuries are the major potential complications of the abdominal surgery for CSF shunts. In this report, we describe an uncommon case of rectus sheath hematoma (RSH) that occurred immediately after a lumboperitoneal shunt and required emergency surgery. RSHs have a reported mortality rate of 4% and require appropriate treatment. Many neurosurgeons rarely have in-depth knowledge of abdominal anatomy. To safely perform CSF shunting, we underscore the importance of precise knowledge of the abdominal anatomy, especially the features of blood vessels.