PMC5344190_01
Abdominopelvic CT Scan: Large left retroperitoneal hematoma, causing severe mass effect upon the adjacent celiac trunk, splenic artery/vein, pancreas, spleen and left kidney.
nihms842940f1.jpg
PMC5344190_01_nihms842940f1.jpg
F1
An abdominopelvic CT-scan revealed the presence of a large left retroperitoneal space hematoma causing severe mass effect upon the adjacent celiac trunk, splenic artery and vein, pancreas, spleen and left kidney (Figure 1).
Abdominopelvic MRI: Large encapsulated retroperitoneal hemorrhage
nihms842940f2.jpg
PMC5344190_01_nihms842940f2.jpg
F2
An abdominal MRI revealed findings compatible with a large 18cm in craniocaudal dimension and 15cm in transverse dimension encapsulated hemorrhage in the left side of the abdomen, which could be retroperitoneal in location or dissecting within the mesentery (Figure 2).
Abdominal arteriogram: Identification of the splenic artery aneurysm located in the middle splenic branch.
nihms842940f4.jpg
PMC5344190_01_nihms842940f4.jpg
F4
An abdominal arteriogram was performed by cardiovascular intervention service revealing an aneurysm of the middle branch of the splenic artery with active leakage (Figure 4).
Splenic catheterism: Status-post embolization of the middle and 3rd branch of splenic artery. Disclosed blockade of splenic aneurysm leakage and blood flow after placement of vascular plugs proximal to the aneurysm (Amplatzer  vascular occluders; St. Jude Medical- MN, USA).
nihms842940f6.jpg
PMC5344190_01_nihms842940f6.jpg
F6
Jude Medical- MN, USA) were done to the middle and third branch of the splenic arteries with complete resolution of the retroperitoneal bleeding (Figure 6).