SPONTANEOUS RECTUS SHEATH HEMATOMA DURING PREGNANCY MIMICKING ABRUPTIO PLACENTA

Sudden disruption of a deep epigastric vessel may result in an abdomin al wall hematoma, which, depending upon its location and size, can pro duce symptoms and clinical findings compatible with a variety of acute intra-abdominal conditions. The literature has noted a predominance o f pregnant patients among those affected with this malady. Such hemato mas are infrequently encountered and early accurate diagnosis could pr event surgical intervention. Unfortunately, the clinical manifestation s of rectus muscle hematoma are sometimes so dramatic that laparotomy is performed under the belief that intra-abdominal pathology is presen t. We present a case of a suspected abruptio placenta misdiagnosed by clinical and ultrasound examination that was subsequently discovered t o be a rectus sheath hematoma at the time of surgery.