Jorge Cuauhtémoc Blake-Siemsen1, Marisol Kortright-Farías2, Dante Rafael Casale-Menier3, Jesús Gámez-Araujo4. 1. Servicio de Cirugía General y Aparato Digestivo, Hospital Ángeles Ciudad Juárez, Ciudad Juárez, Chihuahua,, México. Electronic address: opumed1@gmail.com. 2. Servicio de Cirugía General y Aparato Digestivo, Hospital Ángeles Ciudad Juárez, Ciudad Juárez, Chihuahua,, México. 3. Servicio de Radiología, Hospital Ángeles Ciudad Juárez, Ciudad Juárez, Chihuahua, México. 4. Servicio de Patología, Hospital Poliplaza Médica, Ciudad Juárez, Chihuahua,, México.
Abstract
BACKGROUND: Bleeding from the small bowel is a rare pathology that represents 5-10% of gastrointestinal bleeding; 0.06% to 5% of cases are due to the presence of diverticula of the small intestine. The majority of diverticula are asymptomatic and present symptoms when there is a complication. CLINICAL CASE: We present the case of a 53-year-old male with a history of chronic renal failure and hypertension. While he was hospitalized due to cerebrovascular disease he recurrently presented lower gastrointestinal bleeding that required blood transfusion on several occasions. Upper gastrointestinal bleeding and colon bleeding were ruled out by endoscopy. It was not until an arteriography was performed that we identified bleeding at proximal jejunum level, and therefore we performed a laparotomy. We present the studies and management that the patient underwent. CONCLUSION: Although jejunal diverticula are rare, they must be included in the differential diagnosis of lower gastrointestinal bleeding when present in a patient. Arteriography is a study of great use in locating the site, provided the bleeding is more than 0.5ml/minute.
BACKGROUND:Bleeding from the small bowel is a rare pathology that represents 5-10% of gastrointestinal bleeding; 0.06% to 5% of cases are due to the presence of diverticula of the small intestine. The majority of diverticula are asymptomatic and present symptoms when there is a complication. CLINICAL CASE: We present the case of a 53-year-old male with a history of chronic renal failure and hypertension. While he was hospitalized due to cerebrovascular disease he recurrently presented lower gastrointestinal bleeding that required blood transfusion on several occasions. Upper gastrointestinal bleeding and colon bleeding were ruled out by endoscopy. It was not until an arteriography was performed that we identified bleeding at proximal jejunum level, and therefore we performed a laparotomy. We present the studies and management that the patient underwent. CONCLUSION: Although jejunal diverticula are rare, they must be included in the differential diagnosis of lower gastrointestinal bleeding when present in a patient. Arteriography is a study of great use in locating the site, provided the bleeding is more than 0.5ml/minute.