Author(s): Marc Paul J. Lopez, MD, FPCS; Jan Miguel C. Deogracias, MD; Sittie Aneza Camille A. Maglangit, MD and Sofia Isabel T. Manlubatan, MD
The duodenum is the most common extra-colonic site of diverticulum. If present, it rarely manifests with symptoms or complications. A case is discussed involving a 78-year-old female who presented with massive upper gastrointestinal bleeding from duodenal diverticula. Due to hemodynamic instability, she eventually underwent duodenal resection, with a side-to-side duodenojejunostomy as a means of restoring intestinal continuity. The postoperative course was unremarkable. The patient was able to feed enterally and had no recurrence of bleeding.
Duodenal diverticula are rarely symptomatic but remain to be a valid differential diagnosis for cases of massive upper gastrointestinal bleeding. It must be recognized in order to provide the most appropriate management. Surgical resection is indicated for patients who present with hemodynamic instability, or failure to improve by conservative or endoscopic means
Key words: upper gastrointestinal bleeding, duodenal diverticulum