Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding

Abstract A 65‐year‐old man with a history of chronic renal failure and ischemic heart disease who was receiving aspirin therapy was admitted for recurrent melena. Initial evaluation revealed severe anemia. Other than a diverticulum in the third part of the duodenum, the findings of upper and lower g...

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Main Authors: Yasuhiko Hamada, Hayato Nakagawa
Format: Article
Language:English
Published: Wiley 2024-11-01
Series:JGH Open
Subjects:
Online Access:https://doi.org/10.1002/jgh3.70051
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author Yasuhiko Hamada
Hayato Nakagawa
author_facet Yasuhiko Hamada
Hayato Nakagawa
author_sort Yasuhiko Hamada
collection DOAJ
description Abstract A 65‐year‐old man with a history of chronic renal failure and ischemic heart disease who was receiving aspirin therapy was admitted for recurrent melena. Initial evaluation revealed severe anemia. Other than a diverticulum in the third part of the duodenum, the findings of upper and lower gastrointestinal endoscopies and computed tomography were unremarkable. Capsule endoscopy detected altered blood in the ileum; however, balloon‐assisted enteroscopy found no definitive source of bleeding. Three years later, he presented with recurrent melena and hemorrhagic shock. Upper gastrointestinal endoscopy identified Dieulafoy's lesion within the duodenal diverticulum. Hemostasis was achieved using hemoclips. No recurrence of bleeding was observed during 4 years of follow‐up. The findings from this case highlight the diagnostic and therapeutic challenges of managing obscure gastrointestinal bleeding due to Dieulafoy's lesion in a diverticulum in the third part of the duodenum. Duodenal diverticular bleeding should be included in the differential diagnoses for patients with obscure gastrointestinal bleeding.
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spelling doaj-art-438d48122e0648eea8cfcf57f278be5d2025-08-20T02:27:58ZengWileyJGH Open2397-90702024-11-01811n/an/a10.1002/jgh3.70051Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleedingYasuhiko Hamada0Hayato Nakagawa1Department of Gastroenterology and Hepatology Mie University Hospital Tsu JapanDepartment of Gastroenterology and Hepatology Mie University Hospital Tsu JapanAbstract A 65‐year‐old man with a history of chronic renal failure and ischemic heart disease who was receiving aspirin therapy was admitted for recurrent melena. Initial evaluation revealed severe anemia. Other than a diverticulum in the third part of the duodenum, the findings of upper and lower gastrointestinal endoscopies and computed tomography were unremarkable. Capsule endoscopy detected altered blood in the ileum; however, balloon‐assisted enteroscopy found no definitive source of bleeding. Three years later, he presented with recurrent melena and hemorrhagic shock. Upper gastrointestinal endoscopy identified Dieulafoy's lesion within the duodenal diverticulum. Hemostasis was achieved using hemoclips. No recurrence of bleeding was observed during 4 years of follow‐up. The findings from this case highlight the diagnostic and therapeutic challenges of managing obscure gastrointestinal bleeding due to Dieulafoy's lesion in a diverticulum in the third part of the duodenum. Duodenal diverticular bleeding should be included in the differential diagnoses for patients with obscure gastrointestinal bleeding.https://doi.org/10.1002/jgh3.70051balloon‐assisted enteroscopyduodenal diverticular bleedingobscure gastrointestinal bleeding
spellingShingle Yasuhiko Hamada
Hayato Nakagawa
Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding
JGH Open
balloon‐assisted enteroscopy
duodenal diverticular bleeding
obscure gastrointestinal bleeding
title Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding
title_full Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding
title_fullStr Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding
title_full_unstemmed Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding
title_short Diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding
title_sort diverticular bleeding in the third part of the duodenum as a cause of overt obscure gastrointestinal bleeding
topic balloon‐assisted enteroscopy
duodenal diverticular bleeding
obscure gastrointestinal bleeding
url https://doi.org/10.1002/jgh3.70051
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AT hayatonakagawa diverticularbleedinginthethirdpartoftheduodenumasacauseofovertobscuregastrointestinalbleeding