Abdominal Wall or Pelvic Hemorrhage Secondary to Injury to the Inferior Epigastric Artery

 

Origin of the inferior epigastric artery: external iliac artery, above the inguinal ligament

 

Course of the inferior epigastric artery: medial and cephalad along the posterior rectus sheath

 

Risk factors for hemorrhage from the inferior epigastric artery:

(1) coagulopathy

(2) iatrogenic abdominal and/or pelvic trauma (paracentesis, surgery, percutaneous drain placement, subcutaneous injection)

(3) other abdominal and/or pelvic trauma (blunt trauma, penetrating trauma such as stabbing)

 

Hemorrhage can usually be demonstrated by arteriography with contrast. Contrast medium-enhanced CT is specific but only 70% sensitive.

 

Embolization is usually an effective intervention.