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Article: Preoperative and intraoperative localisation of gastrointestinal bleeding of obscure origin

TitlePreoperative and intraoperative localisation of gastrointestinal bleeding of obscure origin
Authors
Issue Date1987
PublisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/
Citation
Gut, 1987, v. 28 n. 7, p. 869-877 How to Cite?
AbstractIn the past six years, 37 patients with gastrointestinal bleeding of obscure origin had their bleeding sites localised preoperatively or intraoperatively. Preoperative investigations followed a regime consisting of endoscopy, barium meal and follow through, small bowel enema, 99mTc pertechnetate scan. 99mTc-labelled red blood cell scan and selective coeliac and mesenteric angiography. Bleeding lesions were localised preoperatively in 36 patients. In one patient, diagnostic laparotomy had to be carried out immediately before any investigation because the bleeding was severe. At operation, angiosarcoma of ileum was found. Unless preoperative investigations showed the lesions to be in anatomically fixed organs like the duodenum or colon, the lesions had still to be found at operation. Palpation and transillumination detected the lesion intraoperatively in 21 patients while only some lesions were found in three patients with multiple lesions. Sigmoidoscopy through enterotomies was required in one patient. Intraoperative enteroscopy was done for small lesions not found grossly at operation in nine patients, to detect additional lesions in three patients or to rule out suspicions lesion shown on preoperative tests in one patient. In another patient with diffuse lymphoma of small bowel bleeding from only a small segment of jejunum, injection of methylene blue intraoperatively through a previously placed angiographic catheter stained the bleeding segment of jejunum blue. This segment was identified easily and resected. These preoperative and intraoperative localisation procedures were simple and effective and we recommend them to be used more freely.
Persistent Identifierhttp://hdl.handle.net/10722/172559
ISSN
2015 Impact Factor: 14.921
2015 SCImago Journal Rankings: 6.474
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLau, WYen_US
dc.contributor.authorFan, STen_US
dc.contributor.authorWong, SHen_US
dc.date.accessioned2012-10-30T06:23:24Z-
dc.date.available2012-10-30T06:23:24Z-
dc.date.issued1987en_US
dc.identifier.citationGut, 1987, v. 28 n. 7, p. 869-877en_US
dc.identifier.issn0017-5749en_US
dc.identifier.urihttp://hdl.handle.net/10722/172559-
dc.description.abstractIn the past six years, 37 patients with gastrointestinal bleeding of obscure origin had their bleeding sites localised preoperatively or intraoperatively. Preoperative investigations followed a regime consisting of endoscopy, barium meal and follow through, small bowel enema, 99mTc pertechnetate scan. 99mTc-labelled red blood cell scan and selective coeliac and mesenteric angiography. Bleeding lesions were localised preoperatively in 36 patients. In one patient, diagnostic laparotomy had to be carried out immediately before any investigation because the bleeding was severe. At operation, angiosarcoma of ileum was found. Unless preoperative investigations showed the lesions to be in anatomically fixed organs like the duodenum or colon, the lesions had still to be found at operation. Palpation and transillumination detected the lesion intraoperatively in 21 patients while only some lesions were found in three patients with multiple lesions. Sigmoidoscopy through enterotomies was required in one patient. Intraoperative enteroscopy was done for small lesions not found grossly at operation in nine patients, to detect additional lesions in three patients or to rule out suspicions lesion shown on preoperative tests in one patient. In another patient with diffuse lymphoma of small bowel bleeding from only a small segment of jejunum, injection of methylene blue intraoperatively through a previously placed angiographic catheter stained the bleeding segment of jejunum blue. This segment was identified easily and resected. These preoperative and intraoperative localisation procedures were simple and effective and we recommend them to be used more freely.en_US
dc.languageengen_US
dc.publisherBMJ Publishing Group. The Journal's web site is located at http://gut.bmjjournals.com/en_US
dc.relation.ispartofGuten_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAngiographyen_US
dc.subject.meshBarium Sulfate - Diagnostic Useen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshEndoscopyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGastrointestinal Hemorrhage - Diagnosisen_US
dc.subject.meshHumansen_US
dc.subject.meshIntraoperative Perioden_US
dc.subject.meshMaleen_US
dc.subject.meshMethylene Blue - Diagnostic Useen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPalpationen_US
dc.subject.meshPreoperative Care - Methodsen_US
dc.subject.meshTechnetium - Diagnostic Useen_US
dc.subject.meshTransilluminationen_US
dc.titlePreoperative and intraoperative localisation of gastrointestinal bleeding of obscure originen_US
dc.typeArticleen_US
dc.identifier.emailFan, ST: stfan@hku.hken_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1136/gut.28.7.869-
dc.identifier.pmid3498667-
dc.identifier.scopuseid_2-s2.0-0023195795en_US
dc.identifier.volume28en_US
dc.identifier.issue7en_US
dc.identifier.spage869en_US
dc.identifier.epage877en_US
dc.identifier.isiWOS:A1987J632900014-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridLau, WY=7402933199en_US
dc.identifier.scopusauthoridFan, ST=7402678224en_US
dc.identifier.scopusauthoridWong, SH=7404589558en_US

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