A 91 year-old female was admitted to our hospital because of hematemesis. Emergency endoscopic examination disclosed an exposed vessel in the large diverticulum of the second part of the duodenum. Clipping of the vessel was performed endoscopically, and no further bleeding took place thereafter. Hemorrhaging from a duodenal diverticulum is a rare condition and only 56 cases have been reported in Japan. Although resection of the diverticulum was the most popular approach for hemostasis formerly, endoscopic procedures such as ethanol injection therapy have recently become more widely used. Clipping was done in 5 cases and failed to stop bleeding in one case. Exposed vessels which are the cause of bleeding from duodenal diverticulum are seen in about a half of the reported cases. Therefore endoscopic clipping procedure, compressing the bleeding vessel directly by metal clip, is thought to be one of the most effective ways of stopping hemorrhaging from duodenal diverticulum.
