Fig. 4. A 77-year-old male patient with a history of pulmonary thromboembolism presented with sudden onset of right upper-quadrant pain. He has been on anti-coagulation with warfarin. (A) The initial computed tomography scan shows a large hematoma at the right side of the ascending mesocolon and omentum. There is also an extravasation (arrow) of contrast media from the right colic artery. (B) Superior mesenteric artery angiogram shows multifocal ectatic and stenotic change (arrows) of the right colic, transverse colic, and ileal branches. There was also active bleeding from the right colic artery. (C) The back door was occluded using five microcoils as well as the n-butyl cyanoacrylate (1:2) proximally. After the embolization, the patient complained of persistent abdominal pain, and a physical exam demonstrated abdominal tenderness. Therefore, explorative laparotomy was planned, and right hemicolectomy was performed.
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