Surgery for a gastric Dieulafoy's lesion reveals an occult bleeding jejunal diverticulum. A case report

BMC Surg. 2012;12 Suppl 1(Suppl 1):S29. doi: 10.1186/1471-2482-12-S1-S29. Epub 2012 Nov 15.

Abstract

Background: Jejunal diverticulosis is an uncommon disease and usually asymptomatic. It can be complicated not only by diverticulitis, but by hemorrhage, perforation, intussusception, volvulus, malabsorption and even small bowel obstruction due to enteroliths formed and expelled from these diverticula.

Methods: We describe a case of an occult bleeding jejunal diverticulum, casually discovered in a patient that was taken to surgery for a Dieulafoy's lesion after unsuccessful endoscopic treatment. We performed a gastric resection together with an ileocecal resection.Macroscopic and microscopic examinations confirmed the gastric Dieulafoy's lesion and demonstrated the presence of another source of occult bleeding in asymptomatic jejunal diverticulum.

Discussion: The current case emphasizes that some gastrointestinal bleeding lesions, although rare, can be multiple and result in potentially life-threatening bleeding. The clinician must be mindful to the possibility of multisite lesions and to the correlation between results of the investigations and clinical condition of the bleeding patient.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arterioles / abnormalities
  • Diverticulum / complications
  • Diverticulum / diagnosis*
  • Gastrointestinal Hemorrhage / complications
  • Gastrointestinal Hemorrhage / diagnosis*
  • Humans
  • Incidental Findings*
  • Jejunal Diseases / complications
  • Jejunal Diseases / diagnosis*
  • Male
  • Stomach / blood supply*
  • Stomach / pathology
  • Stomach / surgery
  • Vascular Malformations / complications
  • Vascular Malformations / surgery*