[Duodenal diverticulum--a therapeutic challenge].
We report the case of an 81-year-old women with a duodenal diverticular bleeding in the second portion of the duodenum. Various therapies are used to halt haemorrhaging in this tissue, including surgical or endoscopic intervention and transarterial embolisation. The lesion was identified and treated endoscopically with hypertonic saline solution and epinephrine. Because of a fistula and a continual bleeding we use a hemoclip two days later. The bleeding was completely controlled. However, a small mucosal defect was noted at the site where the hemoclip was applied, and an operation was necessary. Finally we discuss the therapy optoins based on a review of the literature.
Abteilung Innere Medizin - Gastroenterologie, Caritas-Klinik Pankow. gottschalk-berlin@t-online.de
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Gottschalk
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Becker
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Stöhr
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Zinner
D000006:Abdomen, Acute / Q000209:etiology / Q000628:therapy; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004240:Diverticulum / Q000175:diagnosis / Q000628:therapy*; D004378:Duodenal Diseases / Q000175:diagnosis / Q000628:therapy*; D004384:Duodenoscopy; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000628:therapy; D007416:Intestinal Perforation / Q000175:diagnosis / Q000628:therapy; D012008:Recurrence; D012086:Reoperation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D013525:Surgical Instruments
D012462:Saline Solution, Hypertonic; D004837:Epinephrine