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Pre-operative localization and embolization for jejunal arteriovenous malformation with massive haemorrhage

¹ Departments of Medical Imaging, ² Emergency Medicine, ³ Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan

Correspondence: Dr Ming-Tsan Lin, Department of Surgery, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei 100, Taiwan. E-mail: linmt{at}ha.mc.ntu.edu.tw

Arteriovenous malformation of the gastrointestinal tract is relatively rare in adults. The most accurate diagnosis is by angiography and pre-operative localization has been reported, including by coil embolization, catheter or guidewire replacement, and intraoperative staining techniques. We report the case of a 20-year-old man with acute and massive small intestinal haemorrhage due to jejunal ateriovenous malformation, which was embolized immediately with N-butyl-2-cyanoacrylate. The technique is rapid and safe under fluoroscopy control and the method can help surgeons with mini-laparotomy or laparoscopic surgery because of the clear localization and stable condition of the patient.