Jejunal arteriovenous malformation, diagnosed by angiography and treated by embolization and catheter-guided surgery: case report and review of literature

Defreyne, Luc; Verstraeten, Valerie; Potter, Christian R. De; Pattyn, Piet; Vos, M. De; Kunnen, Marc

doi:10.1007/s002619900303

Cited by 9 publications

(8 citation statements)

References 22 publications

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“…The same group also reported the intraoperative use of Doppler ultrasound to detect intestinal AVMs [ 8 ]. Defreyne et al reported the intraoperative use of a methylene blue dye injection to visualize the location of small intestine AVM [ 9 ]. Recently, Ono et al reported that an intraoperative indocyanine green dye injection and examination with a fluorescent scope could localize jejunal AVMs [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic resection of idiopathic jejunal arteriovenous malformation after metallic coil embolization

Itatani

Obama

et al. 2018

surg case rep

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BackgroundArteriovenous malformations (AVM) developed in the small intestine are rare, and it is sometimes difficult to identify and treat bleeding from small intestinal AVMs endoscopically because of their localization. We present a case of a jejunal AVM successfully treated with the combination of metallic coil embolization and laparoscopic surgery.Case presentationA 50-year-old woman with a history of repetitive gastrointestinal bleeding was admitted to the hospital. Selective angiography revealed a jejunal AVM that was treated with metallic coil embolization. However, the lesion rebled 3 months later, and it was embolized again with metallic coils. Considering the risk of rebleeding, we performed laparoscopic resection of the jejunal AVM. Under laparoscopy alone, it was impossible to detect the lesion of the AVM. We used X-ray fluoroscopy intraoperatively to detect the metallic coils at the AVM. Partial resection of the jejunum with the AVM was performed followed by functional end-to-end anastomosis. The patient was discharged from the hospital without any complications after the surgery.ConclusionsThe combination of metallic coil embolization by angiography and laparoscopic surgery with X-ray fluoroscopy can be effective for patients with repetitive bleeding from jejunal AVM.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic resection of idiopathic jejunal arteriovenous malformation after metallic coil embolization

Itatani

Obama

et al. 2018

surg case rep

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“…This typically results in the staining of a segment of bowel 10 to 40 cm in length, which allowed for the operating surgeon to more accurately define the affected segment, resulting in more specific and successful surgery. [16][17][18] A similar technique has also been used to identify the source of OGIB in infants. 19 More recently, Stauffer et al, 20 García-Barrasa et al, 21 and Stanojević et al 22 have also successfully used this tech-nique.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Superselective Mesenteric Angiography and Methylene Blue Injection for Localization of Obscure Gastrointestinal Bleeding

et al. 2013

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Localizing obscure gastrointestinal bleeding can be a clinical challenge, despite the availability of various endoscopic, imaging, and visceral angiographic techniques. We reviewed the management of patients presenting with obscure gastrointestinal bleeding during the period from 2005 to 2011. Four patients had preoperative localization of the bleeding site with superselective mesenteric angiography, which was confirmed by the use of intraoperative methylene blue injection. This novel technique allowed us to identify the abnormal pathology, and, consequently, resection of the implicated segment of small bowel was performed without any postoperative complications. Final histology showed that 2 patients had arteriovenous malformations: one had a benign hemangioma of the small bowel, and the other had chronic ischemic ulceration in the ileum. Superselective mesenteric angiography combined with intraoperative localization with methylene blue is an important and innovative technique in the management of patients with unclear sources of gastrointestinal bleeding and allows for effective hemorrhage control with a focused and therefore limited bowel resection.

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“…Visceral arteriography and embolotherapy have been shown to be effective for the diagnosis and treatment of GIH in non-HHT patients (28,29). The site of hemorrhage can be identified by the location of intraluminal extravasation of contrast material or direct identification of vascular malformations.…”

Section: Discussionmentioning

confidence: 99%

“…The most common source of bleeding in these patients were ulcers. In one non-HHT patient, a jejunal AVM was the source of bleeding and showed intermittent contrast medium extravasation during angiography (28). The jejunal artery was embolized with polyvinyl alcohol and the patient was asymptomatic for four months.…”

Section: Discussionmentioning

confidence: 99%

Embolization of a Duodenal Arteriovenous Malformation in Hereditary Hemorrhagic Telangiectasia: Case Report and Review of the Literature

Inouye

Marcon

Pugash

et al. 2003

Canadian Journal of Gastroenterology

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A 68-year-old man with hereditary hemorrhagic telangiectasia presented with recurrent, intermittent gastrointestinal hemorrhage. Transfusion of a total of 27 units of red blood cells was required over the three months before admission. Upper and lower endoscopy did not reveal a source of bleeding and a technetium-labelled red blood cell scan was noncontributory. Angiography demonstrated a duodenal arteriovenous malformation originating from a superior mesenteric artery branch. Embolization of the arteriovenous malformation was performed with resolution of gastrointestinal hemorrhage and reduced requirement for blood transfusion. The utility of trans-catheter embolization in the management of duodenal arteriovenous malformations in hereditary hemorrhagic telangiectasia is discussed.

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Jejunal arteriovenous malformation, diagnosed by angiography and treated by embolization and catheter-guided surgery: case report and review of literature

Cited by 9 publications

References 22 publications

Laparoscopic resection of idiopathic jejunal arteriovenous malformation after metallic coil embolization

Laparoscopic resection of idiopathic jejunal arteriovenous malformation after metallic coil embolization

Preoperative Superselective Mesenteric Angiography and Methylene Blue Injection for Localization of Obscure Gastrointestinal Bleeding

Embolization of a Duodenal Arteriovenous Malformation in Hereditary Hemorrhagic Telangiectasia: Case Report and Review of the Literature

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