| Autor: |
Nilima A. Patwardhan, Michael D. Wertheimer, David A. Phillips, Richard Swanson, John K. Zawacki |
| Rok vydání: |
1996 |
| Předmět: |
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| Zdroj: |
Surgery. 119:714-717 |
| ISSN: |
0039-6060 |
| DOI: |
10.1016/s0039-6060(96)80199-1 |
| Popis: |
LOCALIZING THE SOURCE o f i n t e rmi t t en t acute b l e e d i n g o f the small bowel is a diagnost ic chal lenge. In contrast , the source for con t inuous acute small bowel b l eed ing is usually easily local ized with d i rec t visual inspec t ion o r endoscopy at surgical explora t ion . T h e source o f intermi t t en t acute gastrointest inal b l eed ing is f requen t ly associated with obscure or igins and can the re fo re be diff icult to d e t e r m i n e and localize at opera t ion . 16 O n e o f the objectives o f surgery for small bowel b l e e d i n g is to l imit the resec t ion to the smallest s e g m e n t possible to co r rec t the defect ; this is of ten difficult to do in the set t ing o f i n t e rmi t t en t acute b leeding . We have d e v e l o p e d a t e c h n i q u e to localize the source o f such int e rmi t t en t small bowel b l e e d i n g c o m b i n i n g p reope ra tive embol i za t ion o f the vessel(s) involved and in t raoperative radiography. T h e t e c h n i q u e appears to be a p romis ing add i t ion to exis t ing t echn iques used by in te rven t iona l radiologists and gene ra l surgeons w h e n faced with such a p rob l em. We r e p o r t h e r e the use o f p reopera t ive selective embol i za t ion o f r a d i o p a q u e microcoils wi thin super io r mesen te r i c artery b ranches to localize the site and source o f i n t e rmi t t en t acute b leeding. Precise local izat ion m i n i m i z e d the a m o u n t o f small bowel excised and faci l i tated the r emova l o f the appropr ia te s e g m e n t even w h e n no b l e e d i n g site o r source cou ld be d e t e r m i n e d . |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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