Fig. 1.

A 60-year-old man with massive upper gastrointestinal hemorrhage. ( a ) Initial celiac angiogram with no evidence of active extravasation. ( b ) Selective angiogram of the gastroduodenal artery (GDA) with no evidence of active extravasation. ( c ) Repeat selective angiogram, after placement of backdoor coils in the right gastroepiploic artery, demonstrating a significant amount of active extravasation into the duodenum from branches from the proximal GDA. ( d ) Common hepatic angiogram after additional embolization with Gelfoam and coil embolization of the GDA and superior pancreaticoduodenal artery; no active bleeding identified.