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Related Concept Videos

Diverticular Disease of the Colon01:27

Diverticular Disease of the Colon

Diverticular disease involves the formation of diverticula—small sac-like outpouchings of the colonic wall—and their complications. It most commonly affects the sigmoid colon due to higher intraluminal pressure and structural vulnerability. It results from structural weakness and increased pressure in the colon, producing pseudodiverticula that may remain silent or progress to inflammation and serious complications.Structure of DiverticulaIn diverticulosis, these outpouchings are...
Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Inflammatory Bowel Disease I: Introduction01:26

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Inflammatory Bowel Disease IV: Clinical Manifestations01:20

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...

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Multimodality Diagnosis of Mesenteric Ischemia
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Published on: July 21, 2023

Massive rectal bleeding from acquired jejunal diverticula.

Sheraz Yaqub1, Birte V Evensen, Kristin Kjellevold

  • 1Department of Gastrointestinal Surgery, Akershus University Hospital, 1478 Lørenskog, Norway. sheraz.yaqub@ahus.no.

World Journal of Emergency Surgery : WJES
|May 17, 2011
PubMed
Summary

Jejunal diverticulosis, though rare, can cause significant rectal bleeding. CT angiography accurately identified a jejunal diverticulum as the source, leading to successful surgical resection and resolution of symptoms.

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Published on: October 29, 2014

Area of Science:

  • Gastroenterology
  • Radiology
  • Surgical Oncology

Background:

  • Small bowel diverticulosis is uncommon, frequently asymptomatic, and rarely found in the jejunum.
  • Jejunal diverticula can lead to severe complications, including massive gastrointestinal hemorrhage.
  • Bleeding from jejunal diverticula is rare (3-8%) and can mimic more common colonic bleeding sources.

Purpose of the Study:

  • To highlight jejunal diverticulosis as a critical differential diagnosis for obscure gastrointestinal bleeding.
  • To present a case of massive rectal bleeding successfully diagnosed and treated.
  • To emphasize the utility of CT angiography in identifying the bleeding source.

Main Methods:

  • Case report of a patient with acute massive rectal bleeding.
  • Diagnostic imaging utilizing abdominal CT angiography to pinpoint the bleeding origin.
  • Surgical intervention involving resection of the affected jejunal segment.

Main Results:

  • Abdominal CT angiography successfully identified a jejunal diverticulum as the source of massive rectal hemorrhage.
  • The patient underwent successful surgical resection of the involved jejunal segment.
  • Post-operative follow-up confirmed the resolution of gastrointestinal bleeding.

Conclusions:

  • Jejunal diverticulosis is an important, albeit rare, cause of obscure gastrointestinal bleeding that warrants consideration.
  • Abdominal CT angiography is an effective tool for localizing bleeding from jejunal diverticula.
  • Surgical resection of the affected segment is the definitive treatment for symptomatic jejunal diverticulosis.