D - Coils

The main risk with embolization here is causing bowel ischemia. Gelfoam is considered a temporary embolic, so it may work but have recurrence later. Glue can safely be used and is good in the setting of coagulopathy but is less controlled. There is a growing use of newer more controlled liquid embolics such as Obsidio and LAVA; however, coils tend to be the most common embolic of choice in this setting.

Embolization was performed with Penumbra LP coils through the 2.0 Fr ProGreat microcatheter. The intermittent bleeding stopped and the patient was discharged two days later.