十二指腸憩室出血の1例

抄録

A 63-year-old man with the chief complaints of hematemesis and melena was admitted to our hospital. Neither gastroscopy nor colonoscopy revealed the source of the bleeding, however, CTE (CT enterography) revealed three giant diverticula arranged in a row in the third portion of the duodenum. Capsule endoscopy (CE) could not be carried out successfully, because the agile patency capsule swallowed prior to the capsule endoscopy was trapped in a duodenal diverticulum. Single balloon enteroscopy revealed an ulcer in one of the duodenal diverticula. Endoscopic clipping of the ulcer was performed prophylactically, which successfully controlled the bleeding.
However, the patient desired to undergo a definitive operation for the diverticular hemorrhage. Histopathologic examination of the resected specimen showed granulation tissue causing narrowing of the blood vessels in the diverticulum with the ulcer treated by clipping.
The findings in this case suggest that CTE may be a useful diagnostic tool in the screening for obscure gastrointestinal bleeding, especially in cases where CE is not available.