Intraoperative fluoroscopic detection of an occult jejunal arteriovenous malformation |
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Authors: | Mukai Motoi Ibusuki Kazuhiko Gotoh Takashi Yamamoto Atsushi Nakashima Ken Mutoh Mitsuru Taniguchi Shoji Kawano Michikazu Kihara Yasushi Koga Kazumi |
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Affiliation: | Department of Surgery, Koga General Hospital, 1749-1 Sudaki, Ikeuchi-cho, Miyazaki 880-0041, Japan. mukai@kgh.or.jp |
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Abstract: | A case of chronic gastrointestinal hemorrhage caused by a small jejunal arteriovenous malformation is presented. After microcatheter and microcoil placement, the patient underwent laparoscopically assisted jejunal resection. Intraoperative localization was accomplished by combined use of methylene blue injection and contrast medium injection. Methylene blue injection demarcated the segment of bowel involved and fluoroscopy by contrast medium injection revealed the arteriovenous malformation. This technique located the arteriovenous malformation during surgery and insured adequate but not excessive bowel resection. |
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