Abstract
Despite the various imaging modalities that are available, the diagnosis of small intestinal bleeding is often difficult, and the identification of the bleeding site is challenging. Cases of massive or continuing bleeding of the small intestine require prompt diagnosis and resection of the bleeding sites. We report 2 cases of massive small intestinal bleeding, diagnosed on emergency abdominal angiography (a 77-year-old male with a low grade B cell lymphoma and a 41-year-old male with an arteriovenous malformation). Soon after the diagnoses were confirmed by angiography, the patients underwent surgery for resection of the bleeding sites. To determine the bleeding sites, an intraoperative dye was infused via the catheters deployed during angiography. It has been reported that abdominal angiography is helpful not only in establishing the diagnosis of small intestinal bleeding, but also for embolizing massive bleeding. Although endovascular embolization is temporarily successful, resection of the bleeding site is essential in many cases. The identification of bleeding sites by intraoperative dye infusion via a catheter following angiography is a successful strategy for the diagnosis and management of massive and continuous bleeding of the small intestine.
