No extravasation of contrast, representing active bleeding, was seen by angiography. The patient underwent superselective arteriography of the SMA to isolate the AVM (Figure 3). Platinum coil embolotherapy was performed, with total occlusion of the vessel feeding the malformation (Figure 4) and resolution of GIH. There were no complications from the procedure. In the following six months there was no history of recurrent GIH; however, the patient required transfusion with six units of RBCs due to ongoing epistaxis.
Figure 3) Selective superior mesenteric arteriogram shows tortuous vessels plus small aneurysms (white arrow) in inferior pancreaticoduodenal territory. The black arrow points to the draining vein of this arte-riovenous malformation
Figure 4) The superior mesenteric anteriogram performed following coil embolotherapy shows no flow through the arteriovenous malformation
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