Preoperative highly selective catheter localization of occult small-intestinal hemorrhage with methylene blue dye
M. L. McDonald, M. B. Farnell, A. W. Stanson and A. M. Ress
Department of Surgery, Mayo Clinic, Rochester, Minn.
In patients with occult lower gastrointestinal bleeding, locating of the
source of the hemorrhage can be quite difficult. While multiple diagnostic
tests may confirm a small bowel source of bleeding, precise localization
allowing a directed, conservative surgical resection may be problematic. We
describe three patients each of whom presented with hemorrhage from the
small intestine. The preoperative use of highly selective angiographic
catheter placement combined with intraoperative methylene blue dye
injection allowed us to precisely locate the source of hemorrhage and to
resect a conservative length of small intestine. This technique has been
successful in the three patients herein, and we believe that it should be
included in the options available to the surgeon.
