Abstract
We report here a case of upper gastrointestinal bleeding from the duodenal diverticulum which was successfully treated by endoscopic local injection therapy with hypertonic saline epinephrine solution. A 66-year-old womam was admitted with hematemesis and melena. While no bleeding foci were founded in the esophagus and stomach, emergency endoscopy determined that actual bleeding site was in the diverticulum in the second portion of the duodenum where an exposed vessel was not visible. Since active bleeding (oozing) persisted, we endoscopically injected hypertonic saline epinephrine solution at the bleeding point. This intervention stopped bleeding. An erosion was found in the diverticulum later on, suggesting that this erosion caused active bleeding. After that, pancreatitis occured. We need to pay attention to not only perforation but also pancreatitis when endoscopic local injection therapy is performed at bleeding from the duodenal diverticulum.
