Presentation
Rectal bleeding
Patient Data
Age: 75 years
Gender: Female
From the case:
Diverticular bleed
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Active extravasation of contrast arising from a small diverticulum at the hepatic flexure.
67 x 33 mm collection in the anterior abdominal wall with thick peripheral enhancement, just above the level of the umbilicus.
Small midline hernia more superiorly containing a loop of uncompromised transverse colon.
From the case:
Diverticular bleed
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- Selective catheterization of the superior mesenteric artery with a Cobra and glide wire, angiography performed.
- Challenging imaging due to bowel mobility and suboptimal breath holds. Using correlation with the CT, the site of bleeding was identified.
- Selective catheterization of the branches of the SMA with a Fathom and renegade catheter.
- 3 small coils deployed (one 3 x 2 mm Tornado and two 4 x 2 mm Tornado).
- Post embolization angiogram demonstrated reduced flow to the region and no active extravasation.
COMMENT:
Coil embolization of branches of the superior mesenteric artery.