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篇名	Palpation of preoperatively inserted indwelling angiocatheter facilitates intraoperative localization of obscure gastrointestinal bleeding of small intestinal origin
作者	Chih-Chiang Hung, Min-Che Lin, Cheng-Chung Wu, Min-Che Lin, Cheng-Chung Wu
卷期/出版年月	45卷4期 (2012/8)
頁次	113-117
摘要	Background: Palpation of the indwelling angiographic catheter inserted before operation to localize obscure gastrointestinal bleeding of small intestinal origin during laparotomy has rarely been reported in the literature. Purpose: The purpose of the study is to investigate the role of palpable indwelling angiocatheter inserted before operation in localizing obscure gastrointestinal bleeding of small intestinal origin during laparotomy. Methods: Between January 2003 and December 2010, seven patients who had a clinical impression of obscure gastrointestinal bleeding of small intestinal origin and angiographic extravasation from the mesenteric artery had an angiocatheter inserted into the distal mesenteric branch. During laparotomy the catheter was palpated to guide subsequent resection of the intestine. The clinical outcomes of these patients were retrospectively reviewed. Results: During laparotomy the retained catheter failed to be palpated in one patient. Six patients underwent segmental resection of intestine under guidance of the palpated catheter. All six patients had positive identification of small bowel bleeding. The yield rate of intraoperative localization was 86% (6 out of 7). Two of the six patients ceased bleeding after operation, but died of underlying disease progression. Four of the six patients had an uneventful postoperative clinical course without recurrent bleeding after a median follow-up period of 25 months. Conclusion: Palpation of the indwelling angiographic catheter selectively left before operation is effective for precisely locating obscure gastrointestinal bleeding of small intestinal origin during laparotomy.
關鍵詞	intraoperative localization;laparotomy;obscure gastrointestinal bleeding;palpable angiocatheter;small intestinal origin
分類	Original article