PREOPERATIVE HIGHLY SELECTIVE CATHETER LOCALIZATION OF OCCULT SMALL-INTESTINAL HEMORRHAGE WITH METHYLENE-BLUE DYE

In patients with occult lower gastrointestinal bleeding, locating of t he source of the hemorrhage can be quite difficult. While multiple dia gnostic tests may confirm a small bowel source of bleeding, precise lo calization allowing a directed, conservative surgical resection may be problematic. We describe three patients each of whom presented with h emorrhage from the small intestine. The preoperative use of highly sel ective angiographic catheter placement combined with intraoperative me thylene blue dye injection allowed us to precisely locate the source o f hemorrhage and to resect a conservative length of small intestine. T his technique has been successful in the three patients herein, and we believe that it should be included in the options availble to the sur geon.