Abdominal wall hematoma in an elderly man.

This report describes an abdominal wall hematoma that occurred in an unusual location and resulted in significant hemorrhage in a generally healthy individual. Angiography-directed therapeutic embolization was halted due to an embolic complication. Evidence of continued hemorrhage led to surgical intervention. After a right flank incision was made, fresh blood as well as approximately 1 L of clotted blood were evacuated from the abdominal wall. After resection of a portion of the twelfth rib, the twelfth intercostal artery was noted to be actively bleeding and was ligated. This operative procedure controlled the patient's blood loss. The etiologies, presenting findings, diagnostic studies, and modes of therapy reported for abdominal wall hematomas are reviewed.