Akute Gastrointestinalblutung bei ausgeprägter Dünndarmdivertikulose
| Autor: | U Kindler, J Lüder, M Friebe, H P Allerödder |
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| Rok vydání: | 2001 |
| Předmět: | |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 126:944-946 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2001-16580 |
| Popis: | HISTORY AND CLINICAL FINDINGS A 58-year-old man was admitted to our hospital after an acute onset of rectal bleeding. He was known to have had recurrent duodenal ulcerative disease, once with upper gastrointestinal haemorrhage. Clinical examination was remarkable only for rectal bleeding. INVESTIGATIONS After application of a nasogastric tube cherry-red blood was evacuated. Upper endoscopy showed only very small mucosal erosion in the stomach and coloscopy demonstrated several non-bleeding diverticula. Small bowel enteroclysis showed severe diverticulosis of the duodenum and jejunum. DIAGNOSIS, TREATMENT AND COURSE We assumed that the extensive duodenojejunal diverticulosis was the most probable cause of this episode of gastrointestinal bleeding because of simultaneous signs of upper and lower gastrointestinal haemorrhage. Because this was the first such episode we preferred a conservative approach. At nineteen months follow-up there was no recurrence of bleeding. CONCLUSION Gastrointestinal hemorrhage is a common cause of hospitalization. After exclusion of the more common bleeding sources small bowel diverticula should be considered as a possible rare cause. Surgical resection of the bleeding bowel part is the procedure of choice, but one of the major problems in such cases is to locate exactly the bleeding site. If the location is uncertain, a more conservative approach may be preferable, especially in haemodynamically stable patients with first-time diverticular bleeding. |
| Databáze: | OpenAIRE |
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