HEMATOMA of the abdominal wall is a well-recognized condition. It was known to Hippocrates and to Galen. 1 However, credit for the first complete record of a case is usually given to Richardson, 2 who in 1857 described the condition in a young man of 28. Since that time many cases of this condition have been described under many names: rupture of the rectus muscle, 2 spontaneous rupture of the epigastric artery, 3 spontaneous hematoma of the abdominal wall, 4 and spontaneous hematoma of the rectus sheath. 5 Aird 1 states that by 1957 more than 150 cases had been described; this was a century after the original description by Richardson. Characteristics Anatomical Considerations. —The rectus sheath muscle originates in the under-surface of the costal cartilages 5, 6, and 7, the xiphoid costal ligament, and the xiphoid. It inserts to the border of the pubis and on the symphysis. The