Background: This case describes a 72-year-old man with substantial lower gastrointestinal bleeding (LGIB) for whom initial diagnostic workup failed to identify the source of bleeding, leading to progressive hemodynamic instability. A thorough reevaluation of the patient's computed tomography scan revealed a duplicated left colic artery originating directly from the aorta, a rare vascular variant not previously reported in the literature. Angiography identified this aberrant artery as the source of diverticular bleeding, guiding successful superselective coil embolization. At a 6-month follow-up, the patient had recovered well with no further evidence of bleeding.
Discussion: Acute LGIB presents a substantial medical challenge because of its diverse etiologies and potential for morbidity and mortality. Although diverticular bleeding is the most common cause of LGIB in western countries, rare anatomic variances can complicate diagnosis and treatment.
Conclusion: Awareness of rare anatomic variations in the setting of acute LGIB with hemodynamic compromise can be critical in improving patient outcomes.
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