Methylene blue enteric mapping for intraoperative localization in obscure small bowel hemorrhage: report of a new technique and literature review: combined intraoperative methylene blue mapping and enterectomy.
BACKGROUND
Small bowel sources of obscure gastrointestinal bleeding present both a diagnostic and therapeutic challenge. Due to the normal external appearance of the vast majority of small bowel lesions that cause obscure gastrointestinal bleeding, multiple methods of intraoperative localization have been reported. When an arteriographic abnormality is found, the use of vital dye enteric mapping is one of the most effective localization techniques.


METHODS
We present a new technique combining superselective mesenteric angiography with methylene blue enteric mapping and small bowel resection performed during the same operative procedure. This technique was successfully applied in a patient with a jejunal arteriovenous malformation. Included is a review of methods of intraoperative localization with a focus on vital dye staining-guided enterectomy.
Division of Vascular Surgery, San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
Shaun M
SM
Gifford
Michael A
MA
Peck
Angel M
AM
Reyes
Jonathan B
JB
Lundy
D001165:Arteriovenous Malformations / Q000601:surgery*; D004396:Coloring Agents; D005260:Female; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D007432:Intraoperative Period; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D008751:Methylene Blue; D008875:Middle Aged; D011859:Radiography; D013653:Tattooing
D004396:Coloring Agents; D008751:Methylene Blue