Ruptured traumatic ovarian artery pseudoaneurysm in a pregnant patient

A woman at 36 weeks' gestation was involved in a motor vehicle crash. She required emergency delivery of a healthy infant by cesarean section. She received anticoagulation, despite a splenic injury, for a possible inferior vena cava clot. She re-presented with new retroperitoneal hemorrhage around the juxtarenal aorta. A computed tomography scan suggested a vague contrast blush anterior to the aorta. Arteriography disclosed a right ovarian artery pseudoaneurysm, which was treated with microcoil embolization. The patient has subsequently recovered fully. In major trauma in pregnant patients, ovarian artery pathology needs to be considered in the differential diagnosis of post-traumatic hemorrhage.