Image diagnosis: abdominal wall hematoma.

Jasmine K Dhaliwal, MD, is a Hospital Medicine Specialist at the San Jose Medical Center in CA. E-mail: [email protected]. Gus M Garmel, MD, FACEP, FAAEM, is a Senior Emergency Medicine Physician at the Kaiser Santa Clara Medical Center, Co-Program Director of the Stanford/Kaiser Emergency Medicine Residency Program, and Clinical Professor (Affiliate) of Surgery (Emergency Medicine) at Stanford University. He is also a Senior Editor for The Permanente Journal. E-mail: [email protected]. A spontaneous abdominal wall hematoma developed in a 70-year-old woman with interstitial lung and mixed connective tissue disease during hospitalization for dyspnea. Diagnosed with a recurrent deep venous thrombosis of her left common femoral vein, enoxaparin by abdominal subcutaneous route and warfarin were administered. Within 48 hours, the patient developed pain, tenderness, and a large area of bruising in the left lower quadrant.