The patient was emergently transferred to a tertiary center for endovascular embolization. Endovascular angiography revealed the above primary bleeding sources. Each artery received Onyx embolization. Immediate post embolization images showed satisfactory control however her time in ICU continued to be turbulent with dependency on vasoactive medications and continued transfusion of blood products. Repeat abdominal CT angiogram confirmed an increase in the size of her retroperitoneal hematoma. The patient continued to deteriorate falling into multiorgan dysfunction syndrome thought to be contributed by abdominal compartment syndrome. An emergency midline laparotomy was performed. The massive hematoma was evacuated with a rough calculated volume of 10 L. No active arterial bleeding was identified, perhaps from the massive hematoma achieving tamponade. Fortunately, the patient made a full recovery.