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Inferior epigastric artery rupture occurs in athletes and during coughing in elderly patients with chronic bronchitis.
The blood spreads within the muscle, but as there is no posterior rectus sheath below the arcuate line - the lower edge of the rectus sheath below the pubic and the umbilicus - it spreads out into the extraperitoneal tissues of the iliac fossa.
If this condition occurs in the right iliac fossa then it may become confused with acute appendicitis.
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