Spontaneous rectus sheath hematoma presenting with acute abdominal pain : A case series and review of the literature.

Abdominal pain causes 5% to 10% of the emergency department (ED) admissions.1-5 One-third of these problems are related to surgery. Most of the diagnoses are nonspecific abdominal pain (34%-52%) or pain with unidentified origin.3,6-8 One of the important tasks of the ED physician is to determine life threatening causes of abdominal pain among the many abdominal pain admissions as well as institute due treatment. Emergency physicians should rule out seri-ous pathological conditions.3,9 Some etiologies do not threaten life but need further investigation.Spontaneous rectus sheath hematoma is one of these causes of abdominal pain. Although rare, it is a serious etiology that under-lies acute-onset abdominal pain and prompts admission to ED. Spontaneous rectus sheath hematoma was diagnosed in four patients admitted to our institution with severe abdominal pain in a two-month period. This report highlights the specific features of the patients and reviews the literature on this entity.