PMC5346827_01
CT angiogram demonstrating active contrast extravasation in the caecum (arrow
GHFBB-10-066-g001.jpg
PMC5346827_01_GHFBB-10-066-g001.jpg
F1
SMA catheter angiogram did not demonstrate any active bleeding
GHFBB-10-066-g002.jpg
PMC5346827_01_GHFBB-10-066-g002.jpg
F2
The coeliac angiogram was firstly negative and the bleeding point was not visible on the superior mesenteric artery angiography possibly due to spasm, as noted on the below catheter angiography (fig.2).
As the bleeding point was known to be from the caecum on CTA, a microcatheter was advanced into distal branches of the ileocolic artery and microcoils placed. After some coils were placed the branch demonstrating the bleeding point was identified (arrow
GHFBB-10-066-g003.jpg
PMC5346827_01_GHFBB-10-066-g003.jpg
F3
A microcatheter was therefore placed into the distal ileocolic artery where the bleed was noted on branches of the ileocolic artery as shown below (fig.3).
final angiogram after a successful embolization of the bleeding point which emanated from distal branches of the ileocolic artery
GHFBB-10-066-g004.jpg
PMC5346827_01_GHFBB-10-066-g004.jpg
F4
The bleed was successful coiled with microcoils (fig.4).