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Case ReportThe patient was born after a 38-week twin gestation and weighing 2,875 g. .He was born second via vaginal breech delivery.The Apgar's scores were 6 of 10 at 1 minute and 8 of 10 at 5 minutes.He briefly received positive end-expiratory pressure because of suspected respiratory distress syndrome and was transferred to the maternity ward the same day.Later that day, he developed feeding difficulties, looked pale, and became less reactive.The serum hemoglobin concentration was 8.1 mmol/L.As bleeding or early onset of sepsis was suspected, resuscitation was started with 10 mg/kg of 0.9% normal saline and antibiotics.Additional laboratory testing ruled out hemolysis and showed a further decrease in hemoglobin concentration to 4.5 mmol/L.Ultrasound was performed in search for a bleeding source and confirmed the presence of a hemoperitoneum (►Fig.1).After having received a double red blood cell transfusion (7.5 mg/kg) and 1 mg of fytomenadion intravenously, the baby was transferred to the neonatal intensive care unit (NICU) of the Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands.On arrival at the NICU, he was hemodynamically stable and without respiratory support.Although he looked pale, he was comfortable, awake, and alert.His abdomen was tender with muscular defense but he was neither distended nor discolored.Nonoperative management was attempted with further correction of coagulopathy.Overnight, the baby Keywords ► splenic injury ► endovascular treatment ► interventional radiology ► neonatal care ► intra-abdominal hemorrhage ► surgical emergency

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