Unal Bulent, Kutlu Ramazan, Aydin Cemalettin, Kayaalp Cuneyt
Department of General Surgery, Turgut Ozal Medical Center, Malatya, Turkey.
Surg Laparosc Endosc Percutan Tech. 2011 Apr;21(2):e97-9. doi: 10.1097/SLE.0b013e31820ce93f.
Angiography is helpful to detect the site of bleeding in patients with overt gastrointestinal bleeding. However, angiography sometimes cannot give bleeding location precisely to the surgeons particularly for small bowel bleedings. We described angiography-directed preoperative guidewire placement for localization of the bleeding during laparotomy. This method was used successfully in a 45-year-old women with overt small intestinal bleeding. Method was simple and effective. Catheter was kept in the artery for 45 minutes, guidewire pointed out the bleeding point as closer as 1 cm and a limited resection of bowel (15 cm) resolved the gastrointestinal bleeding. There was no complication because of surgery or interventional radiology, and the patient was discharged on day 6 uneventfully.
血管造影术有助于检测明显胃肠道出血患者的出血部位。然而,血管造影术有时无法向外科医生精确提供出血位置,尤其是对于小肠出血。我们描述了血管造影术引导下的术前导丝放置,用于在剖腹手术期间定位出血部位。该方法在一名45岁明显小肠出血的女性患者中成功应用。方法简单有效。导管在动脉中保留45分钟,导丝将出血点定位至近1厘米范围内,有限的肠段切除(15厘米)解决了胃肠道出血问题。未出现因手术或介入放射学导致的并发症,患者于第6天顺利出院。