Surgical resection with arterial coil embolization for recurrent massive bleeding due to jejunal angiodysplasia : a case report

초록

Gastrointestinal bleeding is associated with high mortality rate and for which it is difficult to make diagnosis and differential diagnosis. Obscure gastrointestinal bleeding represents about 5% of all gastrointestinal bleeds. Small bowel angiodysplasia is rare but important cause of intestinal bleeding that is difficult to diagnosis and treat. Bleeding site localization is a important procedure in case of small bowel bleeding requiring surgical intervention. The purpose of this case report is determination of the bleeding foci before surgery is helpful in the operative stage. And touching the intravascular coil material, we could accurately determine the area of bleeding in the small intestine. We report our experience with a case of jejunal angiodysplasia, which was localized with selective arterial embolization and coiling using an array of embolic and contrast agents, and then resected surgically. Selective arterial coil insertion to treat small bowel bleeding preoperatively not only makes the surgery safer by stabilizing the patient’s hemodynamics, but is also very useful for localizing the lesion intraoperatively.