Middle Colic Artery Branch Aneurysm Presenting as Spontaneous Hemoperitoneum

Rupture of a middle colic artery branch aneurysm is a rare presentation of visceral artery aneurysms. We report a case of a 53-year-old male complaining of acute-onset abdominal pain found to have a massive intraabdominal hematoma secondary to a leaking branch aneurysm of the middle colic artery. The patient underwent laparotomy and ligation of the aneurysm after an attempted endovascular intervention. Following the case report, a review of the literature entailing incidence, presentation, possible etiologies, and potential management strategies is presented.