Aberrant Inferior Pancreaticoduodenal Artery During Upper Gastrointestinal Bleed Embolization

Transcatheter arterial embolization (TAE) is a well-validated treatment for patients with non-variceal upper gastrointestinal (GI) bleeding who have failed endoscopic techniques. We present a case of a patient with duodenal ulcer bleeding that persisted despite endoscopic intervention. A gastroduodenal artery (GDA) embolization was performed; however, recurrence of bleeding warranted further embolization of inferior pancreaticoduodenal artery (IPDA). The IPDA – anterior and posterior branches – had two different origins from the middle colic artery and a replaced right hepatic artery respectively. To our knowledge, this is the first report of this IPDA branching pattern. Knowledge of common and uncommon anatomical variants of mesenteric arteries is paramount to proper interventional management of GI bleeding.