Superselective transcatheter arterial embolization of iatrogenic inferior epigastric artery after paracentesis: Unusual manifestation of hemoperitoneum

INTRODUCTION: Paracentesis is a safe procedure and can be performed as a therapy or diagnosis in cancer patients, liver cirrhosis, heart or liver failure. PRESENTATION OF CASE: 59-year-old man with alcoholic liver cirrhosis with ascites and coagulation abnormalities. After diagnostic paracentesis he presented hemodynamic instability with signs of hypovolemic shock and hemoperitoneum. Computed angiotomography with signs of active bleeding and pseudoaneurysm at the site of paracentesis. DISCUSSION: The interventional radiology unit was referred and submitted to arteriography, which demonstrated active bleeding from the left lower epigastric artery. It was successfully treated by transcatheter embolization with 100−300 μm PVA particles. CONCLUSION: Transcatheter embolization with PVA particles is a fast, safe, minimally invasive, reliable method with a high technical success rate for the treatment of active bleeding resulting from injury to the lower epigastric artery.