title: [Angiodysplasia in a jejunal diverticulum as an unusual cause of lower gastrointestinal bleeding].
abstract: Most of intestinal diverticula are found in the jejunum, followed by the terminal ileum. Therefore they can easily be detected either by enteroscopy or ileocolonoscopy. Mostly the patients are asymptomatic so that it is a surprising finding without therapeutic consequences. But if a patient has an unclear enemea or malabsorption problems for which no explanation has been found in upper or lower gastrointestinal endoscopy, it is suggested to do an enteroscopy. We present the case of a 62-year-old woman who presented to our clinic with a first episode of melena. Although she needed blood transfusions no source of bleeding was found in the common diagnostic examinations such as upper and lower endoscopy and X-ray of the intestine. However, in the X-ray and the enteroscopy jejunal diverticula were seen on which angiodysplasias, detected in mesenteric angiography, projected. Because of the impossibility of stopping the bleeding by endoscopic interventions, the patient was referred to surgery and made an uneventful recovery. The hemoglobin done three months later was stabile and the patient was without any symptoms.
authors.affiliation: Medizinische Klinik C, Klinikum der Stadt Ludwigshafen.
authors.forename: C
authors.initials: C
authors.lastname: Elste
authors.forename: H E
authors.initials: HE
authors.lastname: Adamek
authors.forename: W
authors.initials: W
authors.lastname: Weber
authors.forename: J C
authors.initials: JC
authors.lastname: Arnold
authors.forename: J F
authors.initials: JF
authors.lastname: Riemann
mesh_terms: D016888:Angiodysplasia / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003113:Colonoscopy; D004240:Diverticulum / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D004724:Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D007583:Jejunum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011859:Radiography