Periampullary diverticulum: a case of bleeding from a periampullary diverticulum.
BACKGROUND
Duodenal diverticula are uncommon and usually asymptomatic. Complications like bleeding, perforation and biliary fistulae are rare. The management of a bleeding duodenal diverticulum can be challenging. With the improvement of endoscopic techniques, many of the cases reported in the literature were managed with endoscopic methods. We present a case report of bleeding duodenal diverticulum.


METHODS
The patient was treated successfully with endoscopic haemostasis during her first epidsode when she initially presented with bleeding duodenal diverticulum, but recurred after 2 months.


METHODS
Despite initial endoscopic haemostasis during her second episode, she rebled after 2 days, necessitating surgical management.


RESULTS
After suture ligation of the ulcer, the patient recovered and there was no more recurrence.


CONCLUSIONS
Periampullary diverticulum is a rare source of gastrointestinal bleeding, which can be challenging to diagnose and treat. A multidisciplinary approach encompassing radiology, endoscopy and surgery is most effective.
Kua
J E H
JE
Department of Surgery, National University Hospital, Singapore.
Seah
A
A
So
J B Y
JB
D000368:Aged; D014670:Ampulla of Vater; D003937:Diagnosis, Differential; D004240:Diverticulum / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D004378:Duodenal Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016558:Hemostasis, Endoscopic / Q000379:methods; D006801:Humans