Karate chops and liver lacerations

To the Editor.— Karate is a fast-growing participation sport due partially to the medical emphasis on the benefits of physical fitness and the individual desire for self-protection in the face of high municipal crime rates. To the best of our knowledge, this letter describes probable complications not previously noted. Report of a Case.— A 39-year-old woman was hospitalized with abdominal pain, nausea, vomiting, and syncope. Six weeks earlier, at her second karate lesson, she received a combination of blows to the right subcostal abdominal region. Roentgenograms the following day of the ribs were normal, and she was treated symptomatically with mild analgesics. On the day of admission she vomited coffee-ground material. Her pulse rate on admission was 110, blood pressure was 90/70 mm Hg, and her temperature was 38.8 C. She had tenderness on palpation of the right anterior chest area. The liver edge was palpable 10 cm below the