Giant rectus sheath hematoma

BACKGROUND: Rectus sheath hematoma (RSH) is an uncommon entity associated with predisposing factors such as anticoagulation. It may mimic more frequent abdominal conditions and its accurate diagnosis is important to focus on the correct treatments and improve morbidity and mortality. CASE PRESENTATION: An elderly patient with shock, abdominal pain, palpable abdominal mass, and anemia was suspected of having a large RSH by point-of-care ultrasound (POCUS), which was then confirmed by computed tomography. Surgery was performed, markedly improving his clinical status. CONCLUSIONS: POCUS has a good sensitivity for the diagnosis of RSH and it is also an excellent tool for patient follow-up. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13089-019-0129-4) contains supplementary material, which is available to authorized users.