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A middle aged person, on anticoagulants for MVR presents with acute drop in Hb, Non invasive tests including endoscopy, colonoscopy along with NM study were negative. Negative angiograms x 2,  still continues to bleed requiring multiple transfusions. Decision was made to perform provocative angiogram before exploring surgical options,

 

[pdf-embedder url=”http://ir4u.info/new/wp-content/uploads/2019/04/provocative.pdf”]

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