Cough-induced catastrophe: superior epigastric artery rupture causing rectus sheath hematoma.

Spontaneous rectus sheath hematoma is a rare cause of acute abdominal pain that may mimic surgical emergencies. We report a 68-year-old man with cough-induced superior epigastric artery rupture causing active hemorrhage. Computed tomography established the diagnosis, and surgical evacuation with vessel ligation achieved successful hemostasis and favorable recovery.