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Background: Sheath hematoma of the rectus abdominis muscle is a rare cause of abdominal pain. It requires a careful diagnosis, which avoid laparotomy. Case report: A 40-year-oldmale playing football, performs an abruptly thoracolumbar hyperextension, presenting immediately a severe and sharp abdominal pain in lower abdomen and inner third of right groin, which made him impossible to continue the activity. Patient required surgery evaluation, fi nding: signs of local peritoneal irritation with rebound tenderness and involuntary guarding. Abdominal ultrasound showed hematoma in the rectus abdominis sheath type II. It was managed conservatively requiring 60 days to perform abdominal exercises. Conclusions: The hematoma rectus sheath, is an uncommon cause of abdominal pain, but should be part of the differential diagnosis of abdominal pain in emergency departments because diagnosis avoids unnecessary laparotomy.

Background: Bipolar fracture dislocations of the clavicle are rare injuries, there are less of 50 cases reported. Usually it is result of high-energy direct trauma. Porral in 1831 described the fi rst case. Management of these injuries has remained controversial ranging from non operative to aggressive surgery. Clinical case: A 50 years old male, who suffered three meters fall over left shoulder, attended initially by empiric with Velpeau for three weeks, patient comes to Emergency Room with fever and purulent material of left sternoclavicular joint exploration. Physical exploration showed: temperature of 38 o C; 2 cm in diameter area with loss of substance, including viewing area bone on left sternoclavicular joint with abundant purulent secretion. Studies showed bipolar dislocation fracture collarbone, exposed in its medial portion with active infection.

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