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January 1966

Acute Anemia and Abdominal Tumor Due to Hemorrhage in Rectus Abdominis Sheath Following Anticoagulant Therapy

Author Affiliations


From the departments of medicine and surgery, The Johns Hopkins University and The Johns Hopkins Hospital, Baltimore.

Arch Intern Med. 1966;117(1):103-107. doi:10.1001/archinte.1966.03870070117018

DEEP EPIGASTRIC artery hemorrhage, with and without rupture of the rectus abdominis muscle, was known to the Greeks in the 5th Century BC and Hippocrates1 made some of the first accurate descriptions of the disorder. Galen2 also wrote on the subject, as did Leonardo da Vinci, who reviewed the condition up to the year 1519. The first case in American literature was probably reported by Richardson3 in 1857. One of the more important papers on lesions of the rectus abdominis muscle was that by Cullen and Brodel4 whose classic paper on the subject, written in 1937, included excellent anatomic descriptions of this muscle. They also attempted to correlate anatomic factors with possible pathophysiologic mechanisms responsible for rectus muscle rupture, with or without epigastric artery hemorrhage. In 1938, Payne5 analyzed 165 cases reported in the literature, and in 1956, Furste6 added 85 additional cases. By

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