Diagnosis and Treatment of Jejunal Diverticular Bleeding by Enterotomy and Intraoperative Endoscopy: A Case Report
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Abstract
Jejunal diverticular bleeding is a rare but potentially life-threatening condition, particularly in elderly patients with underlying comorbidities such as cardiovascular disease. It can be challenging to diagnose and treat, which can delay diagnosis and lead to unsatisfactory clinical outcomes. Even with the advancements in endoscopic technology, conventional surgical intervention remains the standard for the treatment of jejunal diverticular bleeding. We report a case of a 70-year-old woman with underlying coronary artery disease on anticoagulant and antiplatelet therapy and underlying hypertension, presenting with recurrent melena and painless hematochezia, accompanied by hypovolemic shock. Despite conservative management and extensive diagnostic workup, the bleeding source remained unidentified until surgical intervention. This case highlights the challenges in diagnosing jejunal diverticular bleeding and the effectiveness of laparotomy with enterotomy and retrograde intraoperative endoscopy in its management.
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