This patient underwent embolization of the bleeding tumor by the interventional radiologist. She was admitted to ITU following this and received three units of red cells. The follow-up CT demonstrated a successful embolization procedure with a resolving retroperitoneal hematoma. 

Wunderlich syndrome is a rare cause of intra-abdominal hemorrhagic shock. Due to the retroperitoneal extravasation of blood, the FAST scan can be negative and falsely reassuring. Furthermore, as in this instance, the patient may have no previous medical history prior to the acute presentation with shock.