The Outcome of Conservative Management and Endovascular Embolization for Spontaneous Intra-abdominal Hemorrhage: A Retrospective Study of Cases from 2016 to 2022

Aim: This retrospective study aimed to evaluate the effectiveness of different management strategies for such patients and explore the clinical outcomes related to these treatments. Methods: This was a retrospective study that included a total of 33 patients who presented with spontaneous intraabdominal hemorrhage at a tertiary care center. The patients’ demographics, clinical characteristics, laboratory findings, treatment modalities (conservative management, endovascular embolization), and outcomes were evaluated. Comparative statistical analyses were performed to assess the impact of treatment approaches on patient outcomes. Results: The majority of patients were female (72.7%) and of Saudi nationality (72.7%). Warfarin (21.2%) and heparin (21.2%) were the most frequently prescribed anticoagulants. The study demonstrated a significant postoperative reduction in systolic blood pressure (p = 0.031), indicating the effectiveness of timely intervention. Furthermore, the conservative management approach showed significant preoperative and postoperative improvements in systolic blood pressure, hemoglobin levels, and platelet counts compared to endovascular embolization. Blood transfusion volumes were significantly lower in the conservative management group (p = 0.002). The presence of rebleeding postoperatively was borderline significant (p = 0.074), favoring patients undergoing endovascular embolization. Conclusion: Effective management of spontaneous intraabdominal hemorrhage in anticoagulated and antiplatelet-treated patients is a multifaceted challenge.