“…4 Blunt trauma, abdominal surgery, coughing, asthma, physical exercise, laparoscopic trocar placement and pregnancy are reported as risk factors predisposing to RSH due to muscle fibers tearing or epigastric vessels rupturing. [1][2][3][4] Below the arcuate line there is only transversalis fascia between peritoneum and posterior rectus sheath, therefore an RSH can mimic acute abdomen. Presenting symptoms and signs consist of abdominal pain and cramping, tachycardia, fever, palpable abdominal mass, ecchymosis, nausea and vomiting.…”