Recurrent hemorrhagic shock from solitary jejunal diverticulum

Abstract

We report the case of recurrent hemorrhagic shock manifested by massive melena and hematemesis in a 67-year-old patient, previously operated in another hospital for an abdominal aortic aneurysm two weeks before. During hospitalization the red blood cell scintigraphy was positive for bleeding in the jejunum. Intraoperative endoscopy was performed to identify a solitary diverticulum at the proximal jejunum. Approximately 70 cm of the involved segment was resected by an end-to-end anastomosis. Postoperative one-year evolution has been favorable, without any evidence of rebleeding. A review of the literature concerning this disease indicates the rarity of a massive bleeding from solitary jejunal diverticulum and the need to consider this condition in patients with gastrointestinal hemorrhage.