J E H Kua1, A Seah, J B Y So. 1. Department of Surgery, National University Hospital, Singapore.
Abstract
INTRODUCTION: Duodenal diverticula are uncommon and usually asymptomatic. Complications like bleeding, perforation and biliary fistulae are rare. The management of a bleeding duodenal diverticulum can be challenging. With the improvement of endoscopic techniques, many of the cases reported in the literature were managed with endoscopic methods. We present a case report of bleeding duodenal diverticulum. CLINICAL FEATURES: The patient was treated successfully with endoscopic haemostasis during her first epidsode when she initially presented with bleeding duodenal diverticulum, but recurred after 2 months. TREATMENT: Despite initial endoscopic haemostasis during her second episode, she rebled after 2 days, necessitating surgical management. OUTCOME: After suture ligation of the ulcer, the patient recovered and there was no more recurrence. CONCLUSION: Periampullary diverticulum is a rare source of gastrointestinal bleeding, which can be challenging to diagnose and treat. A multidisciplinary approach encompassing radiology, endoscopy and surgery is most effective.
INTRODUCTION: Duodenal diverticula are uncommon and usually asymptomatic. Complications like bleeding, perforation and biliary fistulae are rare. The management of a bleeding duodenal diverticulum can be challenging. With the improvement of endoscopic techniques, many of the cases reported in the literature were managed with endoscopic methods. We present a case report of bleeding duodenal diverticulum. CLINICAL FEATURES: The patient was treated successfully with endoscopic haemostasis during her first epidsode when she initially presented with bleeding duodenal diverticulum, but recurred after 2 months. TREATMENT: Despite initial endoscopic haemostasis during her second episode, she rebled after 2 days, necessitating surgical management. OUTCOME: After suture ligation of the ulcer, the patient recovered and there was no more recurrence. CONCLUSION: Periampullary diverticulum is a rare source of gastrointestinal bleeding, which can be challenging to diagnose and treat. A multidisciplinary approach encompassing radiology, endoscopy and surgery is most effective.