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Complicated duodenal-jejunal diverticulosis: case report
Il Giornale Di Chirurgia
|December 20, 2018
Summary
Severe upper gastrointestinal bleeding, though rare, can stem from small intestine diverticula. This case highlights the critical need for surgical intervention in life-threatening complications of duodenal diverticulosis.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Diagnostic Imaging
Background:
- Upper gastrointestinal bleeding, including melaena, often indicates underlying diseases.
- Small intestine diverticula are an infrequent cause (0.06%-5%) of such bleeding, typically remaining asymptomatic until complications arise.
Observation:
- An 88-year-old male presented with severe anemia, asthenia, and melaena.
- Esophagogastroduodenoscopy revealed duodenal stenosis and a blood clot; CT scan showed gastric and duodenal dilation with a duodenal diverticulum.
- The patient experienced hemorrhagic shock, necessitating emergency surgery for a bleeding duodenal diverticulum adherent to the pancreas.
Findings:
- A bleeding duodenal diverticulum, a rare cause of severe gastrointestinal hemorrhage, was identified.
- Surgical resection with a Roux-en-Y bypass was performed due to the diverticulum's complications and adherence to the pancreas.
Implications:
- Duodenal diverticulosis is a rare condition, often managed conservatively.
- Surgical intervention is reserved for rare, complicated, and life-threatening cases of duodenal diverticulosis, as demonstrated in this case report.
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