Angiography confirms occlusion of the left renal artery just beyond its origin. It is unclear whether this represents dissection or transection though given the relatively small haematoma in the vicinity of the left renal artery, a dissection is favoured.
Inferior mesenteric angiography demonstrates a discontinuous segment in the mid descending colon (marginal artery fails to fill over a distance of 7cm). This is in close proximity to the anterior pararenal bleeding. The possibility of mesenteric artery tear with subsequent occlusion is raised.
The left renal artery stump was coiled using 4 mm x 15 cm and a 3 mm x 12 cm Interlock detachable microcoils.