Spontaneous hematoma of the rectus abdominis sheath

The spontaneous hematoma of rectus abdominis sheath is a rare condition which usually presents as acute abdomen. We report our experience with 19 patients, most of them on treatment with oral anticoagulants. The most common symptoms were abdominal pain and palpable tumor. Twenty-six percent required blood transfusion. Ecography and computerized tomography were useful for diagnosis. Treatment was mainly conservative and was the mode of choice; surgery was left only for those patients who had hemodynamic changes or infection of the hematoma.