CASE REPORT article
Front. Med.
Sec. Gastroenterology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1621874
This article is part of the Research TopicAdvances in Venous InterventionsView all 3 articles
Laparoscopy and methylene blue staining angiography for precise synchronous resection of small intestinal vascular malformations: A case report
Provisionally accepted
Zhang Zhiwei1,2,3
Chen Junqiang1*- 1Jinhua Central Hospital, Jinhua, China
- 2Zhejiang university, jinhua, China
- 3Jinhua central hospital, jinhua, China
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Background: Chronic intestinal bleeding caused by vascular malformations is uncommon. Locating these small intestinal vascular malformations with precision during surgery remains a challenge. With the rapid development of digital subtraction angiography(DSA), the detection of small intestinal vascular malformations has become easier. However, heterochronous resection of the diseased small intestine may still have negative results even with accurate location of the malformed vessels because of the quick excretion of the contrast agent. Case summary: A 69-year-old female presented with recurrent melena lasting for over three years, including a recent aggravation two days prior to admission. DSA revealed abnormal contrast uptake at the distal part of the first branch of the left superior mesenteric artery. Enhanced computed tomography (CT) scan confirmed the presence of vascular malformations in the small intestine. DSA and methylene blue staining were further utilized in a hybrid operating room to locate the vascular malformation of the small intestine. Laparoscopy-assisted synchronous resection of the stained intestine was performed simultaneously, effectively resolving the intestinal bleeding associated with the malformed vessels. The patient was discharged on postoperative day 5 without complication. She experienced no complications, such as intestinal fistula and rehematochezia, at the six-month follow-up. Conclusion: With increased experience, laparoscopy and methylene blue staining angiography may offer a safe and feasible method for synchronous resection of small intestine vascular malformations.
Keywords: chronic intestinal bleeding, Laparoscopy, Methylene blue staining, Angiography, small intestinal vascular malformations
Received: 02 May 2025; Accepted: 05 Aug 2025.
Copyright: © 2025 Zhiwei and Junqiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chen Junqiang, Jinhua Central Hospital, Jinhua, China
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