Typical of rectus sheath hematoma is -

Ans. is 'c' i.e., Firm painful mass Rectus sheath hematoma* Rectus sheath hematoma is an uncommon and often clinically misdiagnosed cause of abdominal pain.* It is the result of bleeding into the rectus sheath from damage to the superior or inferior epigastric arteries or their branches or from a direct tear of the rectus muscle.* The emergency physician should be familiar with rectus sheath hematoma because it can mimic almost any abdominal condition.* While usually a self-limiting entity, rectus sheath hematoma can cause hypovolemic shock following sufficient expansion, with associated mortality.Clinical features of rectus sheath hematomaA) Symptoms* Common historical features of rectus sheath hematoma (RSH) include acute abdominal pain, fever, nausea, and vomiting.B) Signsi) Vital signs# A low-grade fever is common in rectus sheath hematoma. The hematoma can be large enough to compromise intravascular volume, with resultant signs of hypovolemic shock including hypotension, tachycardia, and tachypnea.ii) Abdominal examination# Typically, the abdominal examination reveals a palpable, painful, firm, nonpulsatile abdominal mass corresponding to the rectus sheath. The mass may be bilobar with a central groove. The mass does not move with respiration. Because the hematoma is deep to the subcutaneous tissue and rectus muscles, the mass is not always palpable, particularly in obese patients.