Duodenal Diverticular Bleeding Treated with Endoscopy or Transcatheter Arterial Embolization: A Report of Two Cases and a Literature Review

Kosuke Kojima; Kazuki Natsui; Takeki Sato; Moeno Sugita; Ryo Goto; Nao Nakajima; Masaki Maruyama; Osamu Isokawa; Shuji Terai

doi:10.2169/internalmedicine.1742-23

REVIEW ARTICLE

Duodenal Diverticular Bleeding Treated with Endoscopy or Transcatheter Arterial Embolization: A Report of Two Cases and a Literature Review

Kosuke Kojima, Kazuki Natsui, Takeki Sato, Moeno Sugita, Ryo Goto, Nao Nakajima, Masaki Maruyama, Osamu Isokawa, Shuji Terai

Author information

Kosuke Kojima
Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Japan
Kazuki Natsui
Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Japan
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan
Takeki Sato
Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Japan
Moeno Sugita
Department of Gastroenterology, Nagaoka Chuo General Hospital, Japan
Ryo Goto
Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Japan
Nao Nakajima
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan
Masaki Maruyama
Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Japan
Osamu Isokawa
Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Japan
Shuji Terai
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan

Keywords: duodenal diverticular bleeding, duodenal diverticulum, endoscopy, transcatheter arterial embolization, hemostasis

JOURNAL OPEN ACCESS

2023 Volume 62 Issue 24 Pages 3565-3569

DOI https://doi.org/10.2169/internalmedicine.1742-23

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Details

Abstract

Duodenal diverticular bleeding (DDB) is extremely rare. We herein report 2 life-threatening cases of DDB successfully treated with endoscopy or transcatheter arterial embolization (TAE) and review 13 cases of DDB reported from Japan. When upper gastrointestinal bleeding of unknown origin is encountered in middle-aged or older adults, DDB should be included in the differential diagnosis. DDB often causes massive bleeding. It is therefore important to judge which is safer and more effective, endoscopy or TAE, based on the general condition of the patient. In addition, it is critical to attempt hemostasis via various strategies, including different gastroscopes and hemostatic devices.

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