Background: Rectus sheath hematoma (RSH) is a rare but potentially dangerous clinical entity that requires medical supervision.
Case report: Here we discuss one such case which describes the fatal course of spontaneous RSH during hospital admission.
Conclusion: Usually, RSH presents as a minimal abdominal wall swelling with self-limiting course but in the case of hematoma and size progression, specific conservative or invasive measures are necessary to prevent serious complications including hypovolemic shock and death.
Keywords: Abdominal wall; Anticoagulation; Hematoma.