Jejunoileal Arteriovenous Malformation

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Abstract
Arteriovenous malformations, submucosal vascular lakes, of the jejunum and ileum which cause chronic gastrointestinal bleeding and anemia are easily identified before operation by selective arteriography but difficult at operation owing to lack of physical signs. A patient who had such a lesion located in the proximal jejunum was studied. The involved segment was easily identified at operation by injection of indigo carmine solution during operation into the involved jejunal artery subselectively catheterized immediately prior to operation. The duration of jejunal staining before resection was 45 min in this case and varied from 35-55 min in 5 other patients who had right colectomy for carcinoma, providing the opportunity to inject accurately in a conveniently located radiology suite before operation. Safe, convenient, longer periods of staining which could be performed at the time of original diagnosis were demonstrated in dog experiments using biologic colloidal C in which the bowel segment was well stained at the time of sacrifice 5 days after injection. There were no gross or microscopic signs of injury to the bowel.