Diverticular bleed

Case contributed by Edward Ganly

Presentation

Rectal bleeding

Patient Data

Age: 75 years
Gender: Female
ct
  • 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.

dsa
  • 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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.