Minimal Resection of Jejuna Dieulafoy's Lesion Using an Intraoperative Fluoroscopic Localization of the Metallic Coils Used in Angiography.
10.4166/kjg.2017.69.2.135
- Author:
Kwang Il SEO
1
;
Won MOON
;
Cheon Woo LEE
;
Seun Ja PARK
;
Moo In PARK
;
Seung Eun KIM
;
Jae Hyun KIM
;
Ki Young YOON
;
Hee Kyung CHANG
Author Information
1. Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea. moonone70@hanmail.net
- Publication Type:Case Report
- Keywords:
Jejunum;
Dieulafoy;
Coil;
Embolization;
Laparotomy
- MeSH:
Adult;
Angiography*;
Arteries;
Colonoscopy;
Contrast Media;
Endoscopy, Gastrointestinal;
Fluoroscopy;
Gastrointestinal Hemorrhage;
Hemorrhage;
Humans;
Ileum;
Intestines;
Jejunum;
Laparotomy;
Postoperative Complications
- From:The Korean Journal of Gastroenterology
2017;69(2):135-138
- CountryRepublic of Korea
- Language:English
-
Abstract:
Dieulafoy's lesions of the Jejunum are extremely rare. Therefore, localization of lesions is very difficult due to their small size and tendency of occasional bleeding. However, it is important to mention the location of the Dieulafoy's lesions to prevent excessive intestinal resections or, even worse, resection of the normal intestine. We report a case of preoperative localization of a Dieulafoy's lesion embolized by a metallic coil that allows a surgeon to accurately identify the bleeding, permitting a minimally invasive surgical treatment. A 25-year-old man presented with massive hematochezia. There was no definite bleeding focus on the upper gastrointestinal endoscopy and colonoscopy. An angiography found a persistent extravasation of the contrast media at the end of straight artery of the mid-jejunal branch, around the terminal ileum, embolized with metallic coils immediately. The combination of embolized metallic coils and intraoperative fluoroscopy allowed accurate identification and minimal laparotomy. Consequently, a highly selective and minimal resection of the jejunum containing the dieulafoy lesion was possible without any postoperative complications.
