Two cases of terminal ileal diverticular bleeding treated successfully with endoscopic hemostasis

Abstract

Case 1: A woman in her 80s and taking aspirin for angina underwent emergency colonoscopy for hematochezia. A diverticulum was found in the terminal ileum, and hemostasis was achieved with clipping. During hospitalization, two additional episodes of hematochezia occurred that required additional clipping. She was discharged on hospital day 16.

Case 2: A man in his 60s taking rivaroxaban for atrial fibrillation underwent emergency colonoscopy for hematochezia, but the bleeding source was not identified. Another episode of hematochezia occurred during hospitalization, and colonoscopy revealed bleeding from a terminal ileal diverticulum. Hemostasis was achieved using clipping and absorbable hemostatic agent. He was discharged on hospital day 10. We experienced two cases of terminal ileal diverticular bleeding that were treated successfully by endoscopic hemostasis. In cases of obscure gastrointestinal bleeding, ileal diverticular bleeding should be considered, with careful inspection of the terminal ileum.