Catastrophic Sequalae Following Percutaneous Intervention in Case of Sigmoidectomy for Sigmoid Volvulus

Injury to the inferior epigastric artery is infrequent and iatrogenic in most cases, which can be fatal and life-threatening in some cases due to unnoticed excessive hemorrhage. We present a 23-year-old male who underwent sigmoidectomy, end-to-end colorectal anastomosis with covering loop ileostomy for sigmoid volvulus. He developed intra-abdominal pus collection one week following surgery, for which ultrasound-guided aspiration was attempted. Post aspiration, the patient developed abdominal distension, pain with a significant drop in hemoglobin. Imaging showed active bleed from the branch of the inferior epigastric artery with massive intra-abdominal hematoma. The hematoma was evacuated, and the bleeding artery was identified and ligated. Postoperatively, there was no further drop in hemoglobin, and the patient was stable and hence discharged.