Superselective mesenteric arterial branch cannulation for intraoperative identification of bleeding intestinal mucosal lesions

The intraoperative localisation of small intestinal bleeding lesions identified at pre-operative angiography has always been difficult, resulting in extensive resections in doubtful cases. We report two patients in whom, at angiography, a small intestinal lesion was noted to be the cause of gastrointestinal haemorrhage. They then underwent superselective mesenteric arterial cannulation at a second angiographic procedure and were operated upon with the angiographic catheter left within the branch responsible for the bleeding. This superselective catheter placement facilitates precise localisation of the bleeding site intraoperatively, enabling limited segmental resection of bowel. Both patients have had no recurrent bleeding episodes.