Abdominal-Wall Hematomas

Arch Surg. 1966;92(2):194-197. doi:10.1001/archsurg.1966.01320200034006.
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HEMATOMA of the abdominal wall is a well-recognized condition. It was known to Hippocrates and to Galen.1 However, credit for the first complete record of a case is usually given to Richardson,2 who in 1857 described the condition in a young man of 28. Since that time many cases of this condition have been described under many names: rupture of the rectus muscle,2 spontaneous rupture of the epigastric artery,3 spontaneous hematoma of the abdominal wall,4 and spontaneous hematoma of the rectus sheath.5 Aird1 states that by 1957 more than 150 cases had been described; this was a century after the original description by Richardson.


Anatomical Considerations.  —The rectus sheath muscle originates in the under-surface of the costal cartilages 5, 6, and 7, the xiphoid costal ligament, and the xiphoid. It inserts to the border of the pubis and on the symphysis. The


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