Laparoscopic Diverticulectomy for Massive Hemorrhage in a Duodenal Diverticulum

Dan, Dilip; Bascombe, Nigel; Maharaj, Ravi; Subramanian, Hariharan; Naraynsingh, Vijay

doi:10.1097/sle.0b013e318241bb15

Cited by 4 publications

(11 citation statements)

References 7 publications

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“…Treatment options include endoscopic techniques to achieve hemostasis, selective arterial embolization and surgical management [2,3,10]. The first case of endoscopic hemostasis of duodenal diverticula bleeding was reported in 1991 by Sim et al [7]. However, the use of endoscopy as the sole management can be limited due to the high incidence of re-bleeding [10].…”

Section: Discussionmentioning

confidence: 99%

“…Complications of duodenal diverticula include mechanical obstruction of the common bile duct, pancreatic duct or duodenum, diverticulitis with perforation, abscess, fistula formation, sepsis and hemorrhage [2]. Hemorrhage from duodenal diverticula is rare and the first case was reported in 1951 by Patterson and Bromberg [3,7]. We present a case of massive gastrointestinal (GI) bleeding from multiple duodenal diverticula.…”

Section: Introductionmentioning

confidence: 99%

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Multiple Duodenal Diverticula: A Rare Cause of Massive Upper Gastrointestinal Bleeding and Hemodynamic Instability

et al. 2015

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Duodenal diverticula are usually asymptomatic and identified incidentally on imaging studies. In this report, we present a case of massive gastrointestinal (GI) bleeding from multiple duodenal diverticula. A 43-year-old man was evaluated for lightheadedness, hematemesis, and melena. Patient was hypotensive and resuscitated with intravenous fluids and blood products. Upper endoscopy revealed multiple diverticula in the bulb, sweep and second portion of the duodenum with active bleeding from specific diverticulum. Epinephrine was injected around the bleeding diverticulum and multiple endoclips were applied. Patient continued to have persistent melena and required multiple units of packed red blood cells. Repeat endoscopy showed active bleeding from another duodenal diverticulum controlled with endoclips. Patient still had persistent bleeding, thus angiography was performed. Celiac artery stenosis was visualized with poststenotic dilatation. Embolization of the gastroduodenal artery could not be performed due to its retrograde flow supplying the hepatic artery proper. Patient underwent exploratory laparotomy with no further bleeding visualized through a gastrostomy. Duodenum diverticulum is a rare cause of massive upper GI hemorrhage. Endoscopy might not be successful in identifying the bleeding site. There is a high incidence of re-bleeding with endoscopic interventions. Surgery remains the definitive treatment in cases with life-threatening hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multiple Duodenal Diverticula: A Rare Cause of Massive Upper Gastrointestinal Bleeding and Hemodynamic Instability

et al. 2015

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“…Duodenum diverticulum is the most common site for diverticular disease of small intestine. The entity was first reported by Chomel in 1710 and the first well-documented report was by Morgagni in 1762 [8] . Duodenal diverticulum is usually an acquired lesion and 60% of patients older than 40 and predominantly occurs in women [11] , [16] .…”

Section: Introductionmentioning

confidence: 97%

“…Elective surgical treatment of asymptomatic diverticulum is not justified. Endoscopic treatment is usually the first-line approach to biliopancreatic complications related to juxtapapillary duodenal diverticulum and also for diverticulum with hemorrhage or other intraluminal lesion related intestinal obstruction complications [1] , [6] , [8] , [9] , [15] , [13] , [17] .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic resection of perforated duodenal diverticulum – A case report and literature review

Yeh¹

2016

International Journal of Surgery Case Reports

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HighlightsEnglish literatures discussing laparoscopic management for complicated duodenal diverticulum were carefully reviewed.Laparoscopic approach showed less complication, shorted hospital stay and better outcome in comparison to conservative, or open surgery.Laparoscopic approach is safe and feasible in selected cases of complicated duodenal diverticulum (laterally located and protruding duodenal diverticulum), it displays better outcome and many advantages of minimally invasive surgery for the patient.

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“…The entity was first reported by Chomel in 1710 and the first well documented report was by Morgagni in 1762 [1]. Duodenal diverticulum is usually an acquired lesion.…”

Section: Introductionmentioning

confidence: 99%

Naujas perforavusio dvylikapirštės žarnos divertikulo gydymas atliekant Roux-en-Y duodenojejunostomiją

Šileikis¹,

Šileikytė²

2017

LietChirur

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Duodenum diverticulum is the most common site for diverticular disease of small intestine. Symptomatic duodenal diverticulum are 1% to 5%, which present with pain, bleeding, inflammation, cholestasis, cholangitis, obstruction, perforation, pancreatitis, or malignant transformation. The most difficult complication is perforation -0.03%. Once duodenal diverticulitis perforation has been diagnosed, traditional management has been simple diverticulectomy and two layer closure of the duodenum with drainage of the retroperitoneum. However, nowadays there is increase in case reports of successful conservative and different surgical treatment. We present our experience by treating duodenal diverticulitis with simple diversion by Roux-en-Y duodenojejunostomy according to Shigeru Fujisaki after unsuccessful conservative treatment. Key words: duodenum diverticulitis, perforation, treatment Dvylikapirštės žarnos divertikulai yra dažniausia divertikuliozės vieta plonojoje žarnoje. Nuo 1 % iki 5 % tokių divertikulų yra simptominiai ir pasireiškia skausmu, kraujavimu, uždegimu, cholestaze, cholangitu, obstrukcija, perforacija, pankreatitu ar piktybine transformacija. Pati sudėtingiausia komplikacija yra perforacija, kuri sudaro 0,03 %. Diagnozavus dvylikapirštės žarnos divertikulo perforaciją, tradicinis gydymas buvo paprasta divertikulektomija ir dvylikapirštės žarnos užsiuvimas dviem sluoksniais su retroperitoninio tarpo drenavimu. Pastaruoju metu aprašoma vis daugiau sėkmingų konservatyvaus ir kitokio chirurginio gydymo atvejų. Mes aprašome savo patirtį, susijusią su dvylikapirštės žarnos divertikulito gydymu atliekant Roux-en-Y duodenojejunostomiją Shigeru Fujisaki metodu po nesėkmingo konservatyvaus gydymo. Reikšminiai žodžiai: dvylikapirštės žarnos divertikultas, perforacija, gydymas 194

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Laparoscopic Diverticulectomy for Massive Hemorrhage in a Duodenal Diverticulum

Cited by 4 publications

References 7 publications

Multiple Duodenal Diverticula: A Rare Cause of Massive Upper Gastrointestinal Bleeding and Hemodynamic Instability

Multiple Duodenal Diverticula: A Rare Cause of Massive Upper Gastrointestinal Bleeding and Hemodynamic Instability

Laparoscopic resection of perforated duodenal diverticulum – A case report and literature review

Naujas perforavusio dvylikapirštės žarnos divertikulo gydymas atliekant Roux-en-Y duodenojejunostomiją

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