An unusual angiogram in a patient with gastrointestinal bleeding

A patient presenting with upper gastrointestinal bleeding had two visceral angiograms, the second of which demonstrated the hepatic veins in the late phase of the hepatic arterial injection. This observation led to the correct diagnosis of hepatic telangiectasia with arteriovenous shunting and the suspicion, subsequently confirmed at endoscopy, of similar-lesions in the gastrointestinal tract. Visualisation of hepatic veins in visceral arteriography is unusual but may, as discussed, be normal.