Spontaneous Abdominal Hemorrhage: The Role of Endovascular Embolization - A Case Report
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Abstract
An intra-abdominal hemorrhage of non-traumatic origin, though rare, is a critical medical emergency. It can result from various causes, including visceral, gynecological, vascular issues, or coagulopathy. When worsened by anticoagulants, it can rapidly escalate into a life-threatening situation. Immediate intervention is essential, often requiring surgical exploration or endovascular embolization to prevent severe complications or death.
A 36-year-old woman with rheumatic heart disease, hypothyroidism, and a recent mitral valve replacement and tricuspid valve repair presented in shock, with 3 months of amenorrhea and symptoms of acute hemoperitoneum. Abdominal CT Aortography revealed a 12.5 x 9.5 x 9.2 cm intraperitoneal hematoma (550 cc), with active bleeding likely originating from a minor branch of the left uterine artery. The patient was on anticoagulants at the time. This case highlights a rare cause of spontaneous hemoperitoneum, where timely endovascular embolization led to a favorable clinical outcome.
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Copyright (c) 2025 Dr Sangita Pandey, Dr Rumi Bhattacharjee, MD, Dr Nakum Ghanshyam, Dr Rashmita Pal, Dr Hardi Patel, MS
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