An unusual cause of abdominal pain: abdominal hematoma.

A 51-year-old man was treated at our hospital for right upper abdominal pain that had developed over the previous two months. Endoscopic inspections performed by other providers had revealed no abnormalities, and he was treated with nonsteroidal anti-inflammatory drugs under an initial diagnosis of intercostal neuralgia. On admission, his laboratory data, including coagulation parameters, were within the normal limits. The patient had no history of blood coagulation disorders, traumatic events or treatment with anticoagulant therapy. Computed tomography (CT) scans revealed a soft tissue mass (20×80 mm) in the right lateral abdominal wall (Picture, arrow). Together with the ultrasound tomography findings, he was diagnosed with a spontaneous lateral abdominal hematoma. Abdominal hematoma formation is uncommon, and the findings of clinical examinations in such cases are often misleading. CT scanning is the gold standard for diagnosis (1). There are previous reports of hematomas occurring after minor trauma, such as those sustained while either coughing or doing yoga (2). Careful examinations and proper imaging investigations are therefore required.