A 53-year-old lady was admitted with decompensated
dengue shock syndrome during the febrile phase,
complicated by massive retroperitoneal bleeding requiring
angioembolization. She was initially stabilized by fluid
resuscitation at emergency department prior to ICU
admission. While in ICU, her haemoglobin level plummeted
from 17.5 g/dL to 5.8 g/dL without any obvious source of
bleeding. She had hemodynamic instability and worsening
acidosis. The abdominal ultrasound performed showed
complex ascites and CT abdomen revealed a large right
retroperitoneal hematoma with ongoing bleeding. The
patient’s hemodynamic was restored and bleeding resolved
after angioembolization of the right L2 lumbar artery and
right phrenic artery.