Urological symptoms as the initial presentation of a spontaneous rectus sheath hematoma

This case presents a large RSH initially presenting with urological symptoms in a 59-year-old woman with a history of gastric bypass and abdominoplasty, who is known with an APC resistance for which she is treated with warfarin 5 mg daily. This case is a clear example of a rare urological presentation of RSH as the patient first presented with an atypical presentation which mimics the clinical presentation of a passed urolithiasis. Clinically, only suprapubic pain and silentious hematuria were present, and no significant abnormalities in laboratory investigations or CT-scan were present.