Vojnosanitetski pregled 2010 Volume 67, Issue 12, Pages: 1029-1032
https://doi.org/10.2298/VSP1012029S
Full text ( 498 KB)
Preoperative identification of bleeding site caused by angiodysplasia of the small bowel by means of selective arteriography and application of methylene blue
Stanojeviċ Goran
Bošnjaković Petar
Stojanoviċ Miroslav
Jovanoviċ Milan
Branković Branko
Radojković Milan
Katić Vuka V.
Background. Small bowel hemorrhages are rare and account for 2-10% of all
gastrointestinal bleedings. In case that surgery is necessary, identification
of the bleeding site is the most important problem. Case report. We presented
here the case of a 65-year old man, admitted for urgent care of massive lower
gastrointestinal bleeding. After reanimation and normalization of vital
parameters, selective arteriography was done. A contrast extravasation site
was identified at the level of jejunal branches of a. mesenterica superior
and labeled by means of methylene blue application. Immediately after we
performed conservative resection of the labeled jejunal loop in 10 cm length
and terminoterminal anastomosis. The preparation was sent for histopathologic
examination - small bowel angiodysplasia was identified. The patient was
monitored in three month intervals in the next two years and new bleeding
events were not observed. Conclusion. Bleeding caused by small bowel
angiodysplasia is a significant diagnostic problem in cases in whom urgent
surgery is required. Combined preoperative selective arteriography and
methylene blue application make possible precise identification of the
bleeding site as well as conservative small bowel surgery, avoiding thus the
risk and danger of malabsorption syndrome.
Keywords: angiodisplasia, intestine, small, angiography, methylene blue, digestive system surgical procedures, diagnosis, treatment outcome
More data about this article available through SCIndeks