In the confidential reporting of this case, Mr. Doe, 58, developed shortness of breath. He was admitted to a local hospital where he underwent various tests to rule out pulmonary embolism.
The hospital staff interpreted a pulmonary angiogram suspicious for, but not diagnostic of, an embolism. Mr. Doe was prescribed Coumadin and injectable Lovenox. He was then discharged from the hospital.
The following day, Mr. Doe returned to the emergency room complaining of severe abdominal pain. A CT scan and ultrasound showed a rectus sheath hematoma with internal bleeding. A rectus sheath hematoma is described as an accumulation of blood in the outer lining or sheath of the rectus abdominis muscle. The condition causes abdominal pain with or without a mass. The collection of blood or the hematoma may be caused by either rupture of the epigastric artery or by a muscular tear.