Intraoperative enteroscopy for bleeding angiodysplasias of small intestine.

Six patients with angiodysplasias of the small intestine were diagnosed preoperatively with selective angiography during the past eight years. Enteroscopy was used to identify these vascular lesions intraoperatively. Lesions were ulcerated in four patients, had a bleeding vessel tip in one patient and appeared as a nonulcerated reddish patch in the other. Exact localization of these lesions allowed limited segmental resection of the small intestine to be performed. With complete enteroscopy, we were confident that no bleeding lesion was left undetected. The feeding artery and vein to the resected intestinal segment were separately cannulated, and the resected specimen was prepared and injected with hot barium-gelatine. The lesions were confirmed histopathologically to be angiodysplasias in all six patients. There was no recurrence of gastrointestinal bleeding at a median follow-up study of 34 months. There were no operative deaths, and no complications arose from enteroscopy.