抄録
A 76-year-old man was admitted to our hospital with melena and loss of consciousness. A contrast-enhanced computed tomography revealed a duodenal diverticulum with extravasation. We then attempted hemostasis by esophagogastroduodenoscopy (EGD) , which revealed blood in the duodenum and a clot in the duodenal diverticulum. Despite using direct and side-viewing endoscopy, the bleeding point was not detected. An emergency angiography of the inferior pancreaticoduodenal artery revealed extravasation near the pancreas head and embolization was performed using a gelatin sponge. Following embolization, there was no extravasation from that area. EGD on the second day of hospitalization revealed an ulcer in the duodenal diverticulum, but there was no bleeding. Oral intake was resumed and the patient was discharged on the 16 th day of hospitalization.
This case demonstrates the effectiveness of transcatheter arterial embolization for duodenal diverticulum hemorrhage, which is difficult to manage using EGD.
