Small bowel hemorrhage: angiographic localization and intervention.

Occult bleeding in the small bowel was localized with mesenteric angiography in 64 patients. Two groups of patients were identified. In the first group comprising 38 patients, bleeding sites were localized by the demonstration of contrast extravasation. In the second group of 26 patients, there was no extravasation. However, other angiographic findings suggested the source of bleeding. No active bleeding was necessary for a positive study in the second group. We conclude that in patients with suspected occult small bowel hemorrhage, mesenteric angiography helps localize the bleeding site. Clinically active bleeding is not always necessary, as angiographic findings other than extravasation may localize the source of hemorrhage.