- The introduction of restraint devices in cars diminished tremendously the mortality caused by motor vehicle accidents. Hand-in-hand with the decline in mortality, a wide spectrum of injuries associated with the use of seat belts has been documented. In this case report we describe a patient who presented with massive hemoperitoneum caused by complete transection of the rectus abdominis muscle due to seat belt injury. To our knowledge, this complex of injury has never been reported before. However, the lesson should be that although such injury of the rectus abdominis muscle can lead to hemoperitoneum and is possible to be diagnosed by computerized tomographic scan, it should be referred to as a warning sign, which requires searching further for other severe intraabdominal injuries.