RUPTURE OF the rectus abdominis muscle, or apoplexy of the deep epigastric artery, was known to physicians of antiquity, but its early recognition has challenged the diagnostic acumen of clinicians of our time. The following is a case report and attempt to evaluate new diagnostic measures and symptomatic clues, which should save the physician from the embarrassment of retrospective diagnosis and lead to immediate surgical treatment.
Report of Case
A 48-year-old, obese, white woman, gravida 4, para 4, entered the Methodist Hospital because of severe, steady pain in the right lower abdomen and right anterior and posterior flank. She had had a cold four days prior to admission and noticed the pain for the first time after a severe coughing spell. The abdominal discomfort was accompanied by nausea and the patient vomited several times a day. She had had a cholecystectomy in 1949 and an exploratory laparotomy in 1953 for