Intraoperative localization of arteriovenous malformation of a jejunum with combined use of angiographic methods and indocyanine green injection : Report of a new technique
| Autor: | Kimimoto Nagashima, Hiroshi Nishihara, Futoshi Kawamata, Mitsuo Kusano, Hiromi Ono, Yasushi Danjo, Masato Kawakami |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
genetic structures ICG fluorescence imaging Combined use Case Report Lesion Jejunum Arteriovenous malformation 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Superior mesenteric artery angiography medicine medicine.diagnostic_test business.industry medicine.disease Small intestine eye diseases Indocyanine green body regions medicine.anatomical_structure chemistry 030220 oncology & carcinogenesis Angiography 030211 gastroenterology & hepatology Surgery Radiology medicine.symptom business Obscure gastrointestinal bleeding |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • The localization of small intestine sources of obscure gastrointestinal bleeding is a challenge. • The use of indocyanine green (ICG) is effective in aiding intraoperative localization. • The ICG fluorescence imaging can visualize the lesion as an arteriovenous malformation. Introduction The localization of small intestine sources of obscure gastrointestinal bleeding has been a challenge. The use of indocyanine green (ICG) is effective in aiding intraoperative localization if a bleeding lesion is identified on angiography. Case presentation A 95-year-old Japanese man presented with hematochezia. Selective angiography of the superior mesenteric artery (SMA) established an arteriovenous malformation (AVM). ICG injection into the feeding vessel was administered intraoperatively, and the demarcated segment of the jejunum was resected. Discussion Diluted ICG was injected in the SMA by intraoperative angiography, and the region could be easily and clearly visualized by the ICG fluorescence imaging; small patchy poolings of ICG were recognized. Ultimately, the region was diagnosed as an AVM of the jejunum. To the best of our knowledge, this is the first reported description of this technique. Conclusion Our new technique of combining selective angiography with intraoperative ICG injection and focused enterectomy is a safe, accurate, and cost-effective treatment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|