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Dengue fever is an acute febrile viral disease caused by the bite of Aedes aegypti
mosquito. It is a major health problem especially in tropical and subtropical areas
including South East Asia and Pakistan. In the past few years, dengue fever has been
endemic in Northern Punjab. Physicians managing dengue fever come across varied and
uncommon complications of dengue fever. We report a case of dengue fever that developed
severe right upper quadrant abdominal pain and induration after extreme retching and
vomiting for 2 days. A rectus sheath hematoma was confirmed on noncontrast computed
tomography (CT). Rectus sheath hematoma as a complication of dengue fever has rarely
been reported before and never from this part of the world. Rectus sheath hematoma
is an uncommon and often clinically misdiagnosed cause of abdominal pain. It is the
result of bleeding into the rectus sheath from damage to the superior or inferior
epigastric artery or their branches or from a direct tear of the rectus muscle. It
can mimic almost any abdominal condition (See Fig.) (See Table).
