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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Massive bleeding from a ruptured artery in jejunal diverticulosis without pre-existing mucosal inflammation or
Chien-Kuo Liu1, Kuo-Ming Chang2
1Department of Surgery, Mackay Memorial Hospital, #92, Sec. 2, Zhong-Shan N. Rd, Taipei, Taiwan. crs.liuck@msa.hinet.net.
Abstract:
A case of massive bleeding from a ruptured artery in jejunal diverticulosis without pre-existing mucosal inflammation or ulceration is presented. A 75-year-old bed-ridden man had massive gastrointestinal bleeding and deteriorated to a state of shock rapidly. Panendoscopy, selective abdominal angiography, and radionuclide scanning were performed, but none of these studies revealed the exact bleeding point. Emergent operation revealed a segment of jejunal diverticulosis with bleeding, and it was resected. Pathologic examination revealed tortuous veins in the submucosa of diverticula and a ruptured artery with evidence of active bleeding in a large diverticulum. No pre-existing mucosal inflammation or ulceration was seen. The bleeding cause is thought to be acquired false diverticular wall tearing of a submucosal artery by bowel distension or unknown moving content.
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