Intraoperatively, the culprit of the injured artery was identified to be one of the muscular branches from the left inferior epigastric artery, which was ligated and secured. Iatrogenic injury to the inferior epigastric artery and deep circumflex iliac artery are very common during abdominal paracentesis. 

This case highlights the importance of performing multi-phases for all patients presented with active bleeding to look for the source and evidence of acute bleeding.

Some of the useful signs to use while assessing the CT scan as demonstrated in this case are:

• sentinel clot sign
• assessing arterial phase for the active contrast extravasation and later looking for pooling of contrast in portovenous and delay phases
• CTA spot sign has been well described for the cerebral hemorrhage, which is also well seen in this case.