A 61-year-old man with a history of NIDDM was admitted for scheduled laparoscopic cholecystectomy performed with 4 trocars. The postoperative course was normal, but on the third day of the operation he presented with a cough followed by a very painful and hard bulging of the entire right anterior rectum. An urgent CAT scan was performed, which showed an increase in attenuation and volume of the anterior rectum of the abdomen with an anterior-superior diameter of about 6 x 20 cm in a craniocaudal direction, compatible with a large haematoma in the right anterior rectum, possibly secondary to a trocar lesion of the epigastric vessels. Initially, the haematocrit was managed conservatively with haematocrit controls, which dropped to two points without the need for transfusion, and finally drained spontaneously through the supraumbilical trocar orifice. The patient was discharged 28 days after surgery. Diagnosis: large abdominal wall haematoma.

