title: Minimal Resection of Jejuna Dieulafoy's Lesion Using an Intraoperative Fluoroscopic Localization of the Metallic Coils Used in Angiography.
abstract: Dieulafoy's lesions of the Jejunum are extremely rare. Therefore, localization of lesions is very difficult due to their small size and tendency of occasional bleeding. However, it is important to mention the location of the Dieulafoy's lesions to prevent excessive intestinal resections or, even worse, resection of the normal intestine. We report a case of preoperative localization of a Dieulafoy's lesion embolized by a metallic coil that allows a surgeon to accurately identify the bleeding, permitting a minimally invasive surgical treatment. A 25-year-old man presented with massive hematochezia. There was no definite bleeding focus on the upper gastrointestinal endoscopy and colonoscopy. An angiography found a persistent extravasation of the contrast media at the end of straight artery of the mid-jejunal branch, around the terminal ileum, embolized with metallic coils immediately. The combination of embolized metallic coils and intraoperative fluoroscopy allowed accurate identification and minimal laparotomy. Consequently, a highly selective and minimal resection of the jejunum containing the dieulafoy lesion was possible without any postoperative complications.
authors.affiliation: Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Kwang Il
authors.initials: KI
authors.lastname: Seo
authors.affiliation: Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Moon
authors.affiliation: Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Cheon Woo
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Seun Ja
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Moo In
authors.initials: MI
authors.lastname: Park
authors.affiliation: Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Departments of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Kosin University College of Medicine, Busan, Korea.
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Yoon
authors.affiliation: Department of Pathology, Kosin University College of Medicine, Busan, Korea.
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Chang
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D000792:Angiography; D003113:Colonoscopy; D003287:Contrast Media / Q000737:chemistry; D004621:Embolization, Therapeutic; D016099:Endoscopy, Gastrointestinal; D005471:Fluoroscopy; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007583:Jejunum / Q000473:pathology* / Q000601:surgery; D008297:Male; D053831:Surgical Fixation Devices / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000628:therapy
chemical_list: D003287:Contrast Media
keywords: Coil; Dieulafoy; Embolization; Jejunum; Laparotomy