A 75-year-old woman was admitted to our hospital with melena. She had a history of chronic kidney disease. Abdominal computed tomography without contrast agent showed diverticula in the ascending colon. Diverticular bleeding in the colon was suspected. She was treated by fasting and blood transfusion. However the bleeding did not stop. We performed colonoscopy to identify the site of bleeding. Colonoscopy revealed oozing of blood from an ileal diverticulum. We diagnosed the patient with diverticular bleeding in the terminal ileum. Five endoscopic clips were applied near the site of bleeding. She had no recurrence of bleeding after the treatment.
It is difficult to detect of bleeding from an ileal diverticulum because of blood pooling, as had been observed in our patient. In patients with lower gastrointestinal bleeding, the terminal ileum should be observed carefully.
