Preoperative highly selective catheter localization of occult small-intestinal hemorrhage with methylene blue dye.

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.