Massive retroperitoneal hemorrhage post bone marrow biopsy mimicking ruptured abdominal aortic aneurysm

We present the case of a 74-year-old man who presented with acute abdominal pain and shock a few hours following a bone marrow biopsy. He had a history of cardiovascular disease and a known abdominal aortic aneurysm (AAA). Emergency CT abdomen revealed a large retroperitoneal hematoma and a 6 cm AAA. The patient underwent emergency repair of aortic aneurysm which was found not to be ruptured. The hematoma was secondary to vascular injury during bone marrow biopsy. We review the complications of bone marrow biopsy and the imaging findings of ruptured AAA.