A 30 year old primigravida complained of a suprapubic lump and difficulty in micturition on the 10th day of a normal vaginal delivery which took place on 7th May, 2001. On examination her pulse was 84/min., blood pressure 140/90mm of Hg and temperature normal. A suprapubic lump measuring 15 x 10 cm. was observed. The overlying skin had a purplish discoloration. Fothergill sign was positive.
Investigations revealed a hemoglobin of 9gm%, total leukocyte count of 7000/ mm3 with a normal differential count and the clotting time of 4 minutes.
Ultrasonography disclosed a large amount of fluid collection in the suprapubic region that extended across the midline. There were clouds of internal echoes at places, suggestive of partial solidification. The collection displaced the urinary bladder downwards and posteriorly, and there was post-void residual urine.
A 37 year old multipara had a normal vaginal delivery th on 8 July, 2001.On the 4th postpartum day she developed dysuria and a suprapubic swelling. Her pulse was 90/ min, blood pressure 130/86mm of Hg, and temperature normal. The swelling had a midline cleavage which suggested prominent recti. The swelling bulged out more distinctly when the patient was asked to tense the abdomen (positive Fothergill sign).
The blood profile showed Hb 8.5 gm%, total leukocyte count 10,000/ cu mm with a normal differential count and the clotting time of 3 minutes.
On ultrasound examination, a heterogeneous mass was demonstrated in both the rectus sheaths. The mass was separated in the midline. The urinary bladder was displaced posteriorly and downwards.
