title: Single incision laparoscopic surgery approach for obscure small intestine bleeding localized by CT guided percutaneous injection of methylene blue.
abstract: BACKGROUND
  Traditionally, localization of small intestine sources of obscure gastrointestinal bleeding has been a challenge. Advances in the field of endoscopy with the introduction of capsule endoscopy and radiographic imaging with computed tomography angiography and visceral angiography have facilitated more accurate visualization of the small intestine. If a bleeding lesion is identified on angiography and surgery is indicated, the use of methylene blue for enteric mapping is very effective to aid intraoperative localization of the culprit. However, when this is not an option, more invasive surgical techniques are required.
  
  
  METHODS
  We present a new technique used in a patient with angiodysplasia of the small intestine, in where preoperative localization was done using percutaneous computed tomography (CT) guided injection of methylene blue dye. This allowed us to perform a single incision laparoscopic small intestine resection of the culprit.
authors.affiliation: Department of Surgery, St Luke's University Hospital, Bethlehem, PA 18015, USA. Electronic address: drjcmg@yahoo.com.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Martinez
authors.affiliation: Department of Radiology, St Luke's University Hospital, Bethlehem, PA, USA.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Thomas
authors.affiliation: Department of Surgery, St Luke's University Hospital, Bethlehem, PA 18015, USA. Electronic address: John.Lukaszczyk@sluhn.org.
authors.forename: John J
authors.initials: JJ
authors.lastname: Lukaszczyk
keywords: CT guided percutaneous localization; Methylene blue; Obscure small intestine bleeding; Single incision laparoscopy