Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Oct 19;9(4):e112-e117.
doi: 10.1055/s-0043-1776111. eCollection 2023 Oct.

Intraoperative Endoscopic-Guided Bowel Resection for Persistent Gastrointestinal Bleeding Caused by Angiodysplasia: A Case Report and Literature Review

Emily Fellows  1   2 , Joy Harris  1 , Tania Kibble  1 , Nicholas M McDonald  2 , Nabeel Azeem  2 , James V Harmon  1
Affiliations
Case Reports

Intraoperative Endoscopic-Guided Bowel Resection for Persistent Gastrointestinal Bleeding Caused by Angiodysplasia: A Case Report and Literature Review

Emily Fellows et al. Surg J (N Y). .

Abstract

Gastrointestinal angiodysplasia is an uncommon condition often associated with significant gastrointestinal bleeding that is resistant to medical therapy. We report the clinical outcomes of two patients who successfully underwent simultaneous intraoperative endoscopic and surgical interventions for the treatment of angiodysplasia. Intraoperative endoscopic guidance was found to be useful in managing hemorrhage caused by angiodysplasia in both patients. Additionally, we performed an analysis of cases reported in the literature. Our review focused on the anatomic location of the resected bowel and the clinical outcomes of patients ( n = 21) with angiodysplasia managed with intraoperative endoscopy reported in the literature.

Keywords: angiodysplasia; bowel resection; gastrointestinal hemorrhage; intraoperative endoscopy.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Photographs taken during intraoperative enteroscopy (case 1). ( A ) Multiple angiodysplastic lesions on intraoperative endoscopy. ( B ) Active bleeding from an angiodysplastic lesion was observed. ( C ) Bleeding resolved after combined argon plasma coagulation (APC) treatment and mechanical clipping. A tattoo was applied to identify the lesion for future reference.
Fig. 2
Fig. 2
Intraoperative images of the surgical team performing bowel resection (case 2). ( A, B ) Surgical team performing transillumination-guided open bowel resection. ( C, D ) Visualization of angiodysplastic lesions during bowel resection.
See this image and copyright information in PMC

References

    1. Jackson C S, Strong R. Gastrointestinal angiodysplasia: diagnosis and management. Gastrointest Endosc Clin N Am. 2017;27(01):51–62. - PubMed
    1. Tartaglia D, Mazzoni A, Puglisi A G, Coccolini F, Chiarugi M. Intra-operative enteroscopy for the identification of obscure bleeding source caused by gastrointestinal angiodysplasias: through a balloon-tip trocar is better. Colorectal Dis. 2020;22(12):2326–2329. - PubMed
    1. Lee J, Hwang S W, Kim J et al.Multiple polypoid angiodysplasia with obscure overt bleeding. Clin Endosc. 2016;49(01):91–96. - PMC - PubMed
    1. Martinez J C, Thomas J L, Lukaszczyk J J. Single incision laparoscopic surgery approach for obscure small intestine bleeding localized by CT guided percutaneous injection of methylene blue. Int J Surg Case Rep. 2014;5(12):1082–1085. - PMC - PubMed
    1. Uhm M S, Kim N, Nah J C et al.Congenital angiodysplasia in a woman presenting with idiopathic jejunal varicosis on angiography. Gut Liver. 2009;3(02):122–126. - PMC - PubMed

Publication types