The authors report an initially successful left gastric artery embolization performed because of massive upper gastrointestinal bleeding; the procedure was complicated by focal gastric and hepatic infarctions. These complications occurred in the absence of underlying factors known to predispose to ischemia. Low-grade gastric bleeding persisting after seemingly successful embolization of the left gastric artery may indicate ischemic gastritis and is an indication for endoscopy. In addition, the presence of a left hepatic artery completely replaced to the left gastric artery should alert one to the potential for hepatic necrosis.

advanced local disease. It serves as a reminder to include prostatic pathology in the differential diagnosis of elderly males presenting with acute LBO, despite colorectal malignancy being far more common. Endoluminal stenting and transanal resection of the prostate have both been described for palliation of symptoms in this setting but may not be appropriate for all patients. 8,10 The choice of intervention must be individualized and based on the specific clinical context with which a clinician is faced. References 1. Gurel B, Ali TZ, Montgomery EA et al. NKX3.1 as a marker of prostatic origin in metastatic tumors.