Acute hypotensive hematochezia due to jejunal diverticular bleed

Abstract

Small bowel diverticulum, though rare, can result in complications including diverticulitis, hemorrhage, intussusception, fistula, perforation, or bacterial overgrowth. Here, we present a case of gastrointestinal bleeding as a complication of jejunal diverticulum, resulting in hemorrhagic shock. The patient had a negative endoscopy and colonoscopy, prompting computed tomography angiogram, which identified one jejunal diverticulum with active contrast extravasation into the lumen of the small bowel. She underwent successful coil embolization, resulting in cessation of bleeding. This case demonstrates the difficult but successful identification of nonsteroidal antiinflammatory drug–induced jejunal diverticular bleeding in the acute emergent setting.

Keywords:

• Duodenal diverticulum
• jejunal diverticular hemorrhage
• jejunal diverticulosis
• small bowel diverticulosis
• small bowel hemorrhage