Journal of Clinical Gastroenterology · 1985 · 22 citations · 0 references
MedicineInternal MedicineSurgeryBowel ManagementGastroenterologyVascular SurgeryAcute Gastrointestinal HemorrhageEmergency LaparotomyGastrointestinal BleedingGastrointestinal EndoscopyGastrointestinal PerforationGastrointestinal SurgeryAcute Lower Gastrointestinal BleedingBleedingIntra-abdominal HemorrhageMassive Gastrointestinal HemorrhageMesenteric VasculatureSmall Bowel BleedingSmall Bowel PerforationSmall Intestinal Bleeding
A 62-year-old man developed massive lower gastrointestinal tract bleeding. Upper endoscopy and superior mesenteric arteriography initially failed to disclose a cause of bleeding. On rebleeding, intra-arterial vasopressin infusion during repeated arteriography caused reflux of dye into the iliac vessels to allow visualization of an arterial-enteric fistula. Exploratory laparotomy subsequently revealed perforation of the small bowel and common iliac artery by a toothpick which had been swallowed.