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Pathogenesis and Management of Abdominal Wall Hematomas

JOHN H. HENZEL, USAF (MC); WALTER J. PORIES, USAF (MC); J. LEWIS SMITH, USAF (MC); DEAN E. BURGET JR., USAF (MC); FRED R. PLECHA, USAF (MC)
Arch Surg. 1966;93(6):929-935. doi:10.1001/archsurg.1966.01330060073004.
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SUDDEN disruption of a deep epigastric vessel may result in an abdominal wall hematoma which, depending on its location and size, can produce symptoms and clinical findings compatible with a variety of acute intraabdominal conditions. Recognized by the physicians of antiquity, such hematomas are an example of an unusual, infrequently encountered clinical entity in which early accurate diagnosis can alleviate anxiety in an alarmed and often markedly uncomfortable patient. Unfortunately, the clinical manifestations of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed believing that intraabdominal pathology is present. In the past almost all case reports and collective reviews have enumerated sudden unexpected trauma, weakened or diseased musculature, and idiopathic etiology as the underlying causes of rectus muscle hematomas. The purpose of this report, which describes three etiologically different cases, is not only to review the history, anatomy, predisposing causes, diagnosis, and treatment of this interesting clinical entity,

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