Application of double-balloon enteroscopy in jejunal diverticular bleeding

World J Gastroenterol. 2010 Nov 28;16(44):5616-20. doi: 10.3748/wjg.v16.i44.5616.

Abstract

Aim: To evaluate the efficacy of endoscopic diagnosis and therapy for jejunal diverticular bleeding.

Methods: From January 2004 to September 2009, 154 patients underwent double-balloon enteroscopy (DBE) for obscure gastrointestinal bleeding. Ten consecutive patients with jejunal diverticula (5 males and 5 females) at the age of 68.7 ± 2.1 years (range 19- 95 years) at Chang Gung Memorial Hospital, Academic Tertiary Referral Center, were enrolled in this study.

Results: Of the 10 patients, 5 had melena, 2 had hematochezia, 2 had both melena and hematochezia, 1 had anemia and dizziness. DBE revealed ulcers with stigmata of recent hemorrhage in 6 patients treated by injection of epinephrine diluted at 1:10 000, Dieulafoy-like lesions in 4 patients treated by deploying hemoclips on the vessels, colonic diverticula in 2 patients, and duodenal diverticula in 3 patients, respectively. Of the 2 patients who underwent surgical intervention, 1 had a large diverticulum and was referred by the surgeon for DBE, 1 received endoscopic therapy but failed due to massive bleeding. One patient had a second DBE for recurrent hemorrhage 7 mo later, which was successfully treated with a repeat endoscopy. The mean follow-up time of patients was 14.7 ± 7.8 mo.

Conclusion: DBE is a safe and effective treatment modality for jejunal diverticular bleeding.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Balloon Occlusion*
  • Diverticulum / complications
  • Diverticulum / diagnosis
  • Diverticulum / therapy*
  • Diverticulum, Colon / diagnosis
  • Diverticulum, Colon / therapy
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Endoscopic / methods*
  • Humans
  • Jejunal Diseases / complications
  • Jejunal Diseases / diagnosis
  • Jejunal Diseases / therapy*
  • Male
  • Middle Aged
  • Recurrence
  • Time Factors
  • Treatment Outcome
  • Young Adult