Intraoperative localization of arteriovenous malformation of a jejunum with combined use of angiographic methods and indocyanine green injection: Report of a new technique

Hiromi Ono, Mitsuo Kusano, Futoshi Kawamata, Yasushi Danjo, Masato Kawakami, Kimimoto Nagashima, Hiroshi Nishihara

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction The localization of small intestine sources of obscure gastrointestinal bleeding has been a challenge. The use of indocyanine green (ICG) is effective in aiding intraoperative localization if a bleeding lesion is identified on angiography. Case presentation A 95-year-old Japanese man presented with hematochezia. Selective angiography of the superior mesenteric artery (SMA) established an arteriovenous malformation (AVM). ICG injection into the feeding vessel was administered intraoperatively, and the demarcated segment of the jejunum was resected. Discussion Diluted ICG was injected in the SMA by intraoperative angiography, and the region could be easily and clearly visualized by the ICG fluorescence imaging; small patchy poolings of ICG were recognized. Ultimately, the region was diagnosed as an AVM of the jejunum. To the best of our knowledge, this is the first reported description of this technique. Conclusion Our new technique of combining selective angiography with intraoperative ICG injection and focused enterectomy is a safe, accurate, and cost-effective treatment.

Original languageEnglish
Pages (from-to)137-140
Number of pages4
JournalInternational Journal of Surgery Case Reports
Volume29
DOIs
Publication statusPublished - 2016 Jan 1
Externally publishedYes

Fingerprint

Indocyanine Green
Arteriovenous Malformations
Jejunum
Injections
Angiography
Superior Mesenteric Artery
Hemorrhage
Gastrointestinal Hemorrhage
Optical Imaging
Health Care Costs
Small Intestine

Keywords

  • Arteriovenous malformation
  • ICG fluorescence imaging
  • Indocyanine green
  • Superior mesenteric artery angiography

ASJC Scopus subject areas

  • Surgery

Cite this

Intraoperative localization of arteriovenous malformation of a jejunum with combined use of angiographic methods and indocyanine green injection : Report of a new technique. / Ono, Hiromi; Kusano, Mitsuo; Kawamata, Futoshi; Danjo, Yasushi; Kawakami, Masato; Nagashima, Kimimoto; Nishihara, Hiroshi.

In: International Journal of Surgery Case Reports, Vol. 29, 01.01.2016, p. 137-140.

Research output: Contribution to journalArticle

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AU - Kawamata, Futoshi

AU - Danjo, Yasushi

AU - Kawakami, Masato

AU - Nagashima, Kimimoto

AU - Nishihara, Hiroshi

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N2 - Introduction The localization of small intestine sources of obscure gastrointestinal bleeding has been a challenge. The use of indocyanine green (ICG) is effective in aiding intraoperative localization if a bleeding lesion is identified on angiography. Case presentation A 95-year-old Japanese man presented with hematochezia. Selective angiography of the superior mesenteric artery (SMA) established an arteriovenous malformation (AVM). ICG injection into the feeding vessel was administered intraoperatively, and the demarcated segment of the jejunum was resected. Discussion Diluted ICG was injected in the SMA by intraoperative angiography, and the region could be easily and clearly visualized by the ICG fluorescence imaging; small patchy poolings of ICG were recognized. Ultimately, the region was diagnosed as an AVM of the jejunum. To the best of our knowledge, this is the first reported description of this technique. Conclusion Our new technique of combining selective angiography with intraoperative ICG injection and focused enterectomy is a safe, accurate, and cost-effective treatment.

AB - Introduction The localization of small intestine sources of obscure gastrointestinal bleeding has been a challenge. The use of indocyanine green (ICG) is effective in aiding intraoperative localization if a bleeding lesion is identified on angiography. Case presentation A 95-year-old Japanese man presented with hematochezia. Selective angiography of the superior mesenteric artery (SMA) established an arteriovenous malformation (AVM). ICG injection into the feeding vessel was administered intraoperatively, and the demarcated segment of the jejunum was resected. Discussion Diluted ICG was injected in the SMA by intraoperative angiography, and the region could be easily and clearly visualized by the ICG fluorescence imaging; small patchy poolings of ICG were recognized. Ultimately, the region was diagnosed as an AVM of the jejunum. To the best of our knowledge, this is the first reported description of this technique. Conclusion Our new technique of combining selective angiography with intraoperative ICG injection and focused enterectomy is a safe, accurate, and cost-effective treatment.

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