Management of life-threatening hemoperitoneum with minimally invasive percutaneous superselective arterial embolization

The management of spontaneous hemoperitoneum centers on clinical suspicion, fluid resuscitation, appropriate early imaging, and therapeutic intervention. Traditionally, explorative laparotomy has been the treatment of choice for idiopathic spontaneous intraabdominal hemorrhage, but as less invasive percutaneous techniques have matured, superselective arterial embolization may play a critical role in emergent treatment. This case report describes a 65-year-old woman with large-volume hemoperitoneum. At angiography, a single pseudoaneurysm of the middle colic artery was identified and treated with superselective endovascular methods.