Arteriovenous malformations of the small intestine.

Arteriovenous malformations of the small intestine are an uncommon cause of gastrointestinal hemorrhage. When we reviewed the records of 406 patients admitted to the hospital because of gastrointestinal blood loss, we found nine patients who had AVMs of the small intestine. We have developed an algorithm that presents a rational diagnostic approach to patients with hemorrhage from the small intestine. Single contrast barium roentgenograms were not helpful in this series. Endoscopy is not helpful unless the scope can be passed to the area of involvement. Arteriography is the most helpful diagnostic maneuver and should be considered early in the work-up for suspected intestinal AVMs. In addition, arteriography can be useful in localizing the precise area of bleeding so that resection can be limited to the involved areas.