The clinical significance of jejunal diverticular disease diagnosed by double-balloon enteroscopy for obscure gastrointestinal bleeding.
BACKGROUND
Jejunal diverticular disease is a rare cause of gastrointestinal bleeding. The reported incidence of this disease is low in the studies of double-balloon enteroscopy.


OBJECTIVE
The aim of this study was to evaluate the clinical features and management of jejunal diverticular disease, diagnosed by double-balloon enteroscopy, at our institution.


METHODS
This was a retrospective study of patients with jejunal diverticular disease conducted from April 2004 to September 2009 at Changhua Christian Hospital. We evaluated the clinical significance of jejunal diverticular disease and the outcome of endoscopic treatment for jejunal diverticular bleeding.


RESULTS
From April 2004 to September 2009, a total of 55 patients underwent double-balloon enteroscopy due to obscure gastrointestinal bleeding. Fifteen of these patients were diagnosed with jejunal diverticular disease (8 men and 7 women, mean age 71 years). Four patients were found to have a single diverticulum. Gastrointestinal bleeding was attributed to jejunal diverticular disease in 12 patients. Six patients received endoscopic treatment in order to achieve hemostasis. One patient received emergency surgery due to uncontrolled bleeding.


CONCLUSIONS
To our knowledge, this is the first study reporting the clinical significance of jejunal diverticular disease diagnosed by double-balloon enteroscopy. We found that obscure GI bleeding was attributed significantly to jejunal diverticular disease.
Yen
Hsu-Heng
HH
Endoscopy Center, Department of Gastroenterology, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua 500, Taiwan. 91646@cch.org.tw
Chen
Yang-Yuan
YY
Yang
Chia-Wei
CW
Soon
Maw-Soan
MS
D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000150:complications* / Q000175:diagnosis*; D058582:Double-Balloon Enteroscopy; D004381:Duodenal Ulcer / Q000150:complications / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications* / Q000175:diagnosis*; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000601:surgery; D012189:Retrospective Studies
J Gastroenterol Hepatol. 2009 Feb;24(2):185-92
19215331
Gastrointest Endosc. 2008 Nov;68(5):1017-9
18514652
J Gastroenterol. 2009;44(9):879-88
19568687
J Gastroenterol. 2000;35(2):159-62
10680673
Surg Today. 2000;30(8):750-3
10955743
Am J Gastroenterol. 2007 Apr;102(4):731-7
17397406
Surg Laparosc Endosc Percutan Tech. 2008 Aug;18(4):398-9
18716542
Surg Clin North Am. 1952 Aug;:1185-96
14950695
Am J Gastroenterol. 1998 Dec;93(12):2523-8
9860418
J Gastroenterol Hepatol. 1996 Oct;11(10):908-10
8912125
Ann Surg. 1934 Dec;100(6):1123-35
17856425
AJR Am J Roentgenol. 2008 May;190(5):1286-90
18430845
N C Med J. 1995 Dec;56(12):605-7
8584057
Gastrointest Endosc. 2006 Nov;64(5):847; author reply 847-8
17055900
Acta Chir Scand. 1960 Nov 25;120:175-9
13729424
Hepatogastroenterology. 2004 Jul-Aug;51(58):1069-72
15239249
Gastrointest Endosc. 2008 Aug;68(2):371-2; discussion 372
18499108
Arch Surg. 1963 May;86:732-45
14012298
N Engl J Med. 2009 Mar 19;360(12):1239-48
19297577
Surg Gynecol Obstet. 1981 May;152(5):621-6
6784259
J Laparoendosc Adv Surg Tech A. 2009 Oct;19(5):637-40
19489675
Dis Colon Rectum. 1992 Apr;35(4):381-8
1582362
Gastrointest Endosc. 2009 Feb;69(2):384-6
18565525
Gastrointest Endosc Clin N Am. 2006 Apr;16(2):377-82
16644465
Gastrointest Endosc. 2001 Feb;53(2):216-20
11174299
Gastrointest Endosc. 2007 Oct;66(4):831-5
17905030
Korean J Gastroenterol. 2007 Oct;50(4):260-4
18159191
Gastrointest Endosc. 2008 Dec;68(6):1209-14
19028234
Dig Liver Dis. 2007 May;39(5):483-7
17379586
Am Surg. 1990 May;56(5):319-24
2110429
Dig Dis Sci. 2009 Oct;54(10):2296-7
19051015
J Gastroenterol. 2008;43(6):434-40
18600387
Endoscopy. 2006 Jan;38(1):42-8
16429354
South Med J. 1988 Nov;81(11):1386-91
3142056
Surg Gynecol Obstet. 1987 Nov;165(5):425-8
3118488
ANZ J Surg. 2003 Aug;73(8):584-9
12887523
Endoscopy. 2007 Mar;39(3):208-15
17385105