We report the case of a sixty-year-old female patient who was admitted to hospital with severe gastrointestinal bleeding originated in the lower part of the gastrointestinal tract associated with unconsiousness. She had a history of chronic atrial fibrillation under treatment with Sintrom ® . On admission, her general state was poor, with pale skin and mucous membranes, and low blood pressure. A blood test revealed that hemoglobin was 5 g/l. A coagulation test revealed an International Normalized Ratio of 3. We proceeded to correct coagulation and to administer a blood transfusion; after hemodinamic stabilization, we performed an arteriography ( Fig. 1), which showed bleeding points associated with the upper mesenteric artery. An urgently indicated operation was carried out, which revealed a massive diverticulosis of the jejunum-ileum without any other findings (Fig. 2). A resection of the involved part of the small bowel was performed with an end-to-end anastomosis. The patient died 24 hours afterwards in the critical care unit from multiple organ failure.
DISCUSSIONDiverticulosis of the jejunum-ileum is rare when compared to diverticular disease of the colon (1); it is a presumably acquired disease that is more frequent in elderly patients. Usually latent, these diverticulae are generally recognized during an urgent laparotomy for their complications. Small-bowel diverticulosis may be complicated by malabsorption due to bacterial overgrowth in excluded loops of small intestine, massive hemorrhage, diverticulitis, perforation, intestinal ob-
Discusión La etiología del hematoma retroperitoneal es variada, correspondiendo más del 50% a patología tumoral, siendo el adenocarcinoma renal la causa más frecuente, seguido del angiomiolipoma (1). Las causas de hemorragia retroperitoneal pueden clasificarse en espontáneas, como consecuencia de patología local (destacando la rotura de aneurisma de aorta abdo
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.