Rare Jejunal Diverticular Bleeding

Massive Gastrointestinal Bleeding Due to Jejunal Diverticula in a Community Hospital: A Case Report and Review of Diagnostic and Therapeutic Options

Small bowel diverticula are rare and often asymptomatic. Severe lower gastrointestinal bleeding from jejunal diverticula is rarely reported and, therefore, should be considered a differential diagnosis in all cases of lower gastrointestinal bleeding with nonconclusive gastroscopy and colonoscopy. In this case report, we discuss a case of a 75-year-old male with massive lower gastrointestinal bleeding from jejunal diverticula. Initial gastroscopy did not reveal the source of bleeding. Repeat upper endoscopy with a pediatric colonoscope identified jejunal diverticula as the likely source of bleeding. Angiography identified the site of extravasation, and successful angioembolization was done by interventional radiology.

Complicated jejunal diverticulitis with unusual presentation

Jejunal diverticulosis is usually an asymptomatic condition characterized by herniation of mucosa through sites of weakening on the mesenteric border of the jejunum, leading to variable number of discrete outpouchings from the bowel. They are usually discovered incidentally on imaging or surgery done for some other reason. Complications such as diverticulitis with perforation and bowel obstruction and life-threatening gastrointestinal bleeding are rare. Our review highlights the correlation between radiological and surgical findings in 2 different cases of complicated jejunal diverticulitis. Both of the cases were successfully managed surgically.