A 61-year-old male with a history of IDDM was admitted for elective laparoscopic cholecystectomy performed with 4 trocars.
The postoperative course is normal, presenting on the third day of the intervention a blow of cough followed by a bulging of the entire right anterior rectum, very painful and hard consistency.
An urgent CT scan showed an increase in attenuation and volume of the anterior rectus abdominis with an anterosuperior diameter of about 6 cm in the direction of the skull secondary lesion vs. a large volume hematoma in the right anterior epig.
Initially it is managed conservatively performing haematocrit controls that fall to two points without need for transfusion, and finally drains spontaneously through the supraumbilical trocar orifice.
The patient was discharged 28 days after surgery.
Diagnosis: large abdominal wall hematoma.
