Abstract
In this report recent experience with a case of non-traumatic rectus sheath hematoma is presented, with some comments based on the literature. A 76-year-old woman was seen at this hospital because of a left lower abdominal painful mass. The patient suddenly recognized abdominal pain on effort. A handgrip-sized mass was palpated with remarkable tenderness and peritoneal irritable sign on the left lower abdomen. After ultrasonography (US) and computed tomography (CT) surgery was performed under a suspicion of intra-abdominal diseases. A hematoma was found in the left lower part of the vagina musculi recti abdominis. This disease is relatively rare and in Japan 79 cases (including this case) have been reported. In this patients group, a mean age is 55.5 years, and the male-to-female ratio is 1:2. The most of inducing factor is coughing, and respiratory diseases are most frequently found as the basal disease. The rate of accurate diagnosis with preoperative US and CT is 83% and is remarkable high percentage compared with 37% without preoperative US or CT. Non-traumatic rectus sheath hematoma, which has often peritoneal irritable sign, is difficult to differentiate from intra-abdominal diseases, so this disease should be borne in mind on medical examination.
