Spontaneous extraperitoneal haemorrhage: computed tomography diagnosis and treatment by selective arterial embolization.

Four cases of extraperitoneal haemorrhage occurring in the setting of anticoagulation or coagulopathy are presented. Treatment of this condition has traditionally consisted of reversal of anticoagulation and supportive therapy. Diagnosis was made on contrast-enhanced computed tomography. The finding of active contrast extravasation was found to be a factor predictive of failure of conservative therapy and, therefore, an indication for angiography and embolization. In all four cases presented in the present paper, the bleeding vessel(s) were identified and significant active bleeding arrested by transcatheter embolization.