Presentation
Hemorrhagic shock due to lower gastrointestinal bleeding. History of Bentall surgery with mechanical aortic valve replacement.
Patient Data
Contrast blush in the midpoint of the left colon on the arterial phase, in keeping with active extravasation of contrast from the first left branch of the inferior mesenteric artery.
Colonic diverticulosis. There are no pseudoaneurysms or dysplastic arteries.
Extended aortic dissection up to the aortic bifurcation, with a patent false and true lumen. Patent superior mesenteric artery, celiac trunk, inferior mesenteric artery, and right renal artery arising from the true lumen. Patent left renal artery arising from the false lumen.
No hemoperitoneum. No peritoneal effusion.
Case Discussion
Active Lower gastrointestinal bleeding from a probable colonic diverticulum. The patient was transferred for hemostatic embolization.
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