Journal of Gastrointestinal Surgery

, Volume 16, Issue 11, pp 2177–2181

Methylene Blue Enteric Mapping for Intraoperative Localization in Obscure Small Bowel Hemorrhage: Report of a New Technique and Literature Review

Combined Intraoperative Methylene Blue Mapping and Enterectomy


  • Shaun M. Gifford
    • Division of Vascular SurgerySan Antonio Military Medical Center
  • Michael A. Peck
    • Division of Vascular SurgerySan Antonio Military Medical Center
  • Angel M. Reyes
    • Department of General SurgeryWomack Army Medical Center
    • Division of Trauma and Acute Care SurgerySan Antonio Military Medical Center
Case Report

DOI: 10.1007/s11605-012-1964-9

Cite this article as:
Gifford, S.M., Peck, M.A., Reyes, A.M. et al. J Gastrointest Surg (2012) 16: 2177. doi:10.1007/s11605-012-1964-9



Small bowel sources of obscure gastrointestinal bleeding present both a diagnostic and therapeutic challenge. Due to the normal external appearance of the vast majority of small bowel lesions that cause obscure gastrointestinal bleeding, multiple methods of intraoperative localization have been reported. When an arteriographic abnormality is found, the use of vital dye enteric mapping is one of the most effective localization techniques.

Case Report

We present a new technique combining superselective mesenteric angiography with methylene blue enteric mapping and small bowel resection performed during the same operative procedure. This technique was successfully applied in a patient with a jejunal arteriovenous malformation. Included is a review of methods of intraoperative localization with a focus on vital dye staining-guided enterectomy.

Copyright information

© The Society for Surgery of the Alimentary Tract 2012