Median sacral artery injury following a bone marrow biopsy successfully treated with selective trans-arterial embolization: a case report

BACKGROUND: Iatrogenic arterial injury during bone marrow biopsy is an extremely rare complication. We present unreported complication of median sacral artery injury that was managed successfully with endovascular treatment. CASE PRESENTATION: A 22-year-old Caucasian man known to have end-stage renal disease secondary to Senior-Loken syndrome presented with anemia. He underwent an investigation with bone marrow biopsy that was complicated by hypotension and a further significant drop in his hemoglobin level. Cross-sectional imaging with computed tomography demonstrated a large abdominopelvic retroperitoneal hematoma and active bleeding of the median sacral artery. A successful lifesaving endovascular trans-arterial embolization was performed on an emergency basis and our patient was discharged in a stable condition a few days later. CONCLUSION: Iatrogenic arterial injury after a bone marrow biopsy is extremely rare. To the best of our knowledge, a median sacral artery injury has not been previously reported. Endovascular trans-arterial embolization is a safe, effective, and minimally invasive therapeutic option.