Spontaneous rectus sheath hematoma: an unusual cause of gross hematuria.

The diagnosis of a spontaneous rectus sheath hematoma, even in anticoagulated patients, requires a high index of suspicion. Gross hematuria is also not infrequent in anticoagulated patients. Although urinary symptoms from a rectus sheath hematoma have been described, generally it would not be considered a common cause of gross hematuria in this population. We report here on 2 cases of spontaneous rectus sheath hematoma spontaneously fistulizing into the bladder and causing gross hematuria.