Our Summary

This research paper describes how a method called Indocyanine green (ICG) fluorescence imaging has been successfully used to find the source of bleeding in the small intestine, which can be hard to pinpoint. The paper details two examples where this technique was used on women who were suffering from internal bleeding that could not be stopped with traditional methods. The ICG method was used during emergency surgery and helped the surgeons to see exactly where the bleeding was coming from. This information allowed the surgeons to remove only the necessary sections of the small intestine, which led to successful outcomes for the patients. This suggests that ICG could be a safe and effective tool for surgeons dealing with difficult-to-find internal bleeding.

FAQs

  1. What is Indocyanine green (ICG) fluorescence imaging and how does it work?
  2. How has ICG been used in the treatment of internal bleeding in the small intestine?
  3. Is ICG considered a safe and effective method for locating internal bleeding during surgery?

Doctor’s Tip

A doctor might tell a patient undergoing bowel resection surgery to ask about the possibility of using Indocyanine green (ICG) fluorescence imaging during the procedure. This technique can help the surgeon locate the source of bleeding more accurately, potentially reducing the amount of intestine that needs to be removed and improving the overall outcome of the surgery. It is important for patients to discuss all available options with their healthcare provider to ensure the best possible outcome.

Suitable For

Patients who may be recommended bowel resection include those with:

  • Intestinal blockages or obstructions
  • Severe inflammation or infection of the intestines (such as in cases of Crohn’s disease or ulcerative colitis)
  • Cancerous or non-cancerous tumors in the intestines
  • Diverticulitis (inflammation or infection of small pouches that can form in the intestines)
  • Trauma or injury to the intestines
  • Chronic intestinal bleeding that cannot be controlled with other treatments

In cases where the source of bleeding in the small intestine is difficult to pinpoint, as described in the research paper, ICG fluorescence imaging may be a helpful tool for surgeons to locate and remove the affected areas.

Timeline

Before bowel resection:

  1. Patient experiences symptoms such as abdominal pain, bloating, diarrhea, constipation, and rectal bleeding.
  2. Patient undergoes diagnostic tests such as colonoscopy, CT scan, and blood tests to determine the cause of their symptoms.
  3. It is determined that the patient requires a bowel resection surgery due to conditions such as bowel obstruction, colorectal cancer, Crohn’s disease, or diverticulitis.

After bowel resection:

  1. Patient undergoes pre-operative preparations such as bowel cleansing and fasting.
  2. Patient undergoes bowel resection surgery, which involves removing the diseased or damaged portion of the bowel.
  3. Patient stays in the hospital for a few days for recovery and monitoring.
  4. Patient gradually starts to reintroduce solid foods into their diet and begins physical activity to aid in recovery.
  5. Patient may experience temporary side effects such as pain, bloating, and changes in bowel habits.
  6. Patient follows up with their healthcare provider for post-operative care and monitoring of their bowel function and overall health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about bowel resection include:

  1. What is the reason for needing a bowel resection?
  2. What are the risks and potential complications associated with the surgery?
  3. What is the expected recovery time and rehabilitation process?
  4. Will I need to make any lifestyle changes after the surgery?
  5. Are there any alternative treatments or procedures that could be considered?
  6. How will the surgery affect my digestive system and bowel function?
  7. Will I need to follow a special diet before or after the surgery?
  8. How long will I need to stay in the hospital after the surgery?
  9. What follow-up care will be necessary after the surgery?
  10. Are there any long-term effects or potential complications to be aware of after the surgery?

Reference

Authors: Aso K, Yagi S, Yamada K, Kato D, Enomoto N, Nohara K, Kitagawa D, Takemura N, Kiyomatsu T, Kokudo N. Journal: Clin J Gastroenterol. 2023 Jun;16(3):349-354. doi: 10.1007/s12328-023-01787-w. Epub 2023 Apr 12. PMID: 37046143