title: The clinical significance of jejunal diverticular disease diagnosed by double-balloon enteroscopy for obscure gastrointestinal bleeding.
abstract: 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.
authors.affiliation: Endoscopy Center, Department of Gastroenterology, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua 500, Taiwan. 91646@cch.org.tw
authors.forename: Hsu-Heng
authors.initials: HH
authors.lastname: Yen
authors.forename: Yang-Yuan
authors.initials: YY
authors.lastname: Chen
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Maw-Soan
authors.initials: MS
authors.lastname: Soon
mesh_terms: 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
references.citation: J Gastroenterol Hepatol. 2009 Feb;24(2):185-92
references.pmid: 19215331
references.citation: Gastrointest Endosc. 2008 Nov;68(5):1017-9
references.pmid: 18514652
references.citation: J Gastroenterol. 2009;44(9):879-88
references.pmid: 19568687
references.citation: J Gastroenterol. 2000;35(2):159-62
references.pmid: 10680673
references.citation: Surg Today. 2000;30(8):750-3
references.pmid: 10955743
references.citation: Am J Gastroenterol. 2007 Apr;102(4):731-7
references.pmid: 17397406
references.citation: Surg Laparosc Endosc Percutan Tech. 2008 Aug;18(4):398-9
references.pmid: 18716542
references.citation: Surg Clin North Am. 1952 Aug;:1185-96
references.pmid: 14950695
references.citation: Am J Gastroenterol. 1998 Dec;93(12):2523-8
references.pmid: 9860418
references.citation: J Gastroenterol Hepatol. 1996 Oct;11(10):908-10
references.pmid: 8912125
references.citation: Ann Surg. 1934 Dec;100(6):1123-35
references.pmid: 17856425
references.citation: AJR Am J Roentgenol. 2008 May;190(5):1286-90
references.pmid: 18430845
references.citation: N C Med J. 1995 Dec;56(12):605-7
references.pmid: 8584057
references.citation: Gastrointest Endosc. 2006 Nov;64(5):847; author reply 847-8
references.pmid: 17055900
references.citation: Acta Chir Scand. 1960 Nov 25;120:175-9
references.pmid: 13729424
references.citation: Hepatogastroenterology. 2004 Jul-Aug;51(58):1069-72
references.pmid: 15239249
references.citation: Gastrointest Endosc. 2008 Aug;68(2):371-2; discussion 372
references.pmid: 18499108
references.citation: Arch Surg. 1963 May;86:732-45
references.pmid: 14012298
references.citation: N Engl J Med. 2009 Mar 19;360(12):1239-48
references.pmid: 19297577
references.citation: Surg Gynecol Obstet. 1981 May;152(5):621-6
references.pmid: 6784259
references.citation: J Laparoendosc Adv Surg Tech A. 2009 Oct;19(5):637-40
references.pmid: 19489675
references.citation: Dis Colon Rectum. 1992 Apr;35(4):381-8
references.pmid: 1582362
references.citation: Gastrointest Endosc. 2009 Feb;69(2):384-6
references.pmid: 18565525
references.citation: Gastrointest Endosc Clin N Am. 2006 Apr;16(2):377-82
references.pmid: 16644465
references.citation: Gastrointest Endosc. 2001 Feb;53(2):216-20
references.pmid: 11174299
references.citation: Gastrointest Endosc. 2007 Oct;66(4):831-5
references.pmid: 17905030
references.citation: Korean J Gastroenterol. 2007 Oct;50(4):260-4
references.pmid: 18159191
references.citation: Gastrointest Endosc. 2008 Dec;68(6):1209-14
references.pmid: 19028234
references.citation: Dig Liver Dis. 2007 May;39(5):483-7
references.pmid: 17379586
references.citation: Am Surg. 1990 May;56(5):319-24
references.pmid: 2110429
references.citation: Dig Dis Sci. 2009 Oct;54(10):2296-7
references.pmid: 19051015
references.citation: J Gastroenterol. 2008;43(6):434-40
references.pmid: 18600387
references.citation: Endoscopy. 2006 Jan;38(1):42-8
references.pmid: 16429354
references.citation: South Med J. 1988 Nov;81(11):1386-91
references.pmid: 3142056
references.citation: Surg Gynecol Obstet. 1987 Nov;165(5):425-8
references.pmid: 3118488
references.citation: ANZ J Surg. 2003 Aug;73(8):584-9
references.pmid: 12887523
references.citation: Endoscopy. 2007 Mar;39(3):208-15
references.pmid: 17385105