title: Application of double-balloon enteroscopy in jejunal diverticular bleeding.
abstract: OBJECTIVE
  To evaluate the efficacy of endoscopic diagnosis and therapy for jejunal diverticular bleeding.
  
  
  METHODS
  From January 2004 to September 2009, 154 patients underwent double-balloon enteroscopy (DBE) for obscure gastrointestinal bleeding. Ten consecutive patients with jejunal diverticula (5 males and 5 females) at the age of 68.7 ± 2.1 years (range 19- 95 years) at Chang Gung Memorial Hospital, Academic Tertiary Referral Center, were enrolled in this study.
  
  
  RESULTS
  Of the 10 patients, 5 had melena, 2 had hematochezia, 2 had both melena and hematochezia, 1 had anemia and dizziness. DBE revealed ulcers with stigmata of recent hemorrhage in 6 patients treated by injection of epinephrine diluted at 1:10 000, Dieulafoy-like lesions in 4 patients treated by deploying hemoclips on the vessels, colonic diverticula in 2 patients, and duodenal diverticula in 3 patients, respectively. Of the 2 patients who underwent surgical intervention, 1 had a large diverticulum and was referred by the surgeon for DBE, 1 received endoscopic therapy but failed due to massive bleeding. One patient had a second DBE for recurrent hemorrhage 7 mo later, which was successfully treated with a repeat endoscopy. The mean follow-up time of patients was 14.7 ± 7.8 mo.
  
  
  CONCLUSIONS
  DBE is a safe and effective treatment modality for jejunal diverticular bleeding.
authors.affiliation: Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 5, Fu-Hsin St., Kwei-Shan, Taoyuan 333, Taiwan.
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Chen
authors.forename: Cheng-Tang
authors.initials: CT
authors.lastname: Chiu
authors.forename: Wei-Pin
authors.initials: WP
authors.lastname: Lin
authors.forename: Ming-Yao
authors.initials: MY
authors.lastname: Su
authors.forename: Chen-Ming
authors.initials: CM
authors.lastname: Hsu
authors.forename: Pang-Chi
authors.initials: PC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion; D004240:Diverticulum / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004241:Diverticulum, Colon / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult