Median sacral artery injury following a bone marrow biopsy successfully treated with selective trans-arterial embolization: a case report

J Med Case Rep. 2016 Feb 24:10:42. doi: 10.1186/s13256-016-0827-5.


Background: Iatrogenic arterial injury during bone marrow biopsy is an extremely rare complication. We present unreported complication of median sacral artery injury that was managed successfully with endovascular treatment.

Case presentation: A 22-year-old Caucasian man known to have end-stage renal disease secondary to Senior-Loken syndrome presented with anemia. He underwent an investigation with bone marrow biopsy that was complicated by hypotension and a further significant drop in his hemoglobin level. Cross-sectional imaging with computed tomography demonstrated a large abdominopelvic retroperitoneal hematoma and active bleeding of the median sacral artery. A successful lifesaving endovascular trans-arterial embolization was performed on an emergency basis and our patient was discharged in a stable condition a few days later.

Conclusion: Iatrogenic arterial injury after a bone marrow biopsy is extremely rare. To the best of our knowledge, a median sacral artery injury has not been previously reported. Endovascular trans-arterial embolization is a safe, effective, and minimally invasive therapeutic option.

Publication types

  • Case Reports

MeSH terms

  • Anemia / pathology*
  • Arteries / injuries*
  • Biopsy, Needle / adverse effects
  • Bone Marrow / pathology*
  • Embolization, Therapeutic*
  • Endovascular Procedures
  • Hematoma / etiology*
  • Hematoma / therapy*
  • Humans
  • Male
  • Retroperitoneal Space
  • Sacrum / blood supply
  • Young Adult