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Article
December 19, 1925

HEMATOMA OCCURRING SPONTANEOUSLY IN SHEATH OF RECTUS ABDOMINIS MUSCLE: CONSIDERATION OF ITS GYNECOLOGIC AND OBSTETRIC SIGNIFICANCE: REPORT OF TWO CASES

JAMA. 1925;85(25):1955-1958. doi:10.1001/jama.1925.02670250029008
Abstract

Rupture of the fibers of the rectus abdominis muscle, when not due to external violence, occurs as the result of strong or unusual contraction, though in a few cases there is a record of nothing more than ordinary muscular effort. As a rule this accident carries with it laceration of the branches of the epigastric vessels, sometimes of the trunks themselves, and, as a result, a hematoma forms within the aponeurotic sheath. This condition is of surgical interest not only because it constitutes a lesion, but also because the signs and symptoms produced lead to misinterpretation in suggesting intraperitoneal disease. When the accident occurs in women, it is nearly always mistaken for some critical form of abdominal or pelvic pathologic condition. Surgical textbooks either omit the subject or refer to it briefly, and gynecologic textbooks make no reference to it. Haubold1 refers to subcutaneous lacerations of the musculature of

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