- 58 year old male with HCV cirrhosis, Esophageal varices, Ascites.
- Hypotensive, intubated and on pressors.
- Paracentesis was attempted from the left side
- Resulted in drop in hemoglobin and bloody aspirate obtained.
- Suspected intraperitoneal bleed.
- CT angiogram performed
Case Differential Diagnosis:
- Arterial bleed
- Inferior epigastric artery
- Venous bleed
- Management options:
- Angiogram + embolization
- Conservative management
- Active extravasation from left Inferior epigastric artery
- Successfully embolized with small coils and particles
- No further bleed
Post paracentesis bleed from left inferior epigastric artery