Laparoscopic diverticulectomy for massive hemorrhage in a duodenal diverticulum.
Hemorrhagic duodenal diverticula are rare and are treated by endoscopy or open diverticulectomy, especially when there is a massive hemorrhage. We report what we believe to be the first instance of urgent laparoscopic diverticulectomy of a large, inflamed duodenal diverticulum with massive hemorrhage. An elderly patient had a screening colonoscopy and additional upper gastrointestinal endoscopy because of vague upper gastrointestinal symptoms; however, both were reported to be normal. She subsequently developed massive hematemesis. Clinical examination revealed a tender right upper quadrant mass and imaging confirmed a large duodenal diverticulum with surrounding inflammatory changes. Urgent laparoscopic diverticulectomy was performed with an uneventful recovery and follow-up. Laparoscopic diverticulectomy should be considered in managing hemorrhagic duodenal diverticula.
Department of Clinical Surgical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, San Fernando General Hospital, Trinidad, West Indies.
Dilip
D
Dan
Nigel
N
Bascombe
Ravi
R
Maharaj
Seetharaman
S
Hariharan
Vijay
V
Naraynsingh
D000369:Aged, 80 and over; D004240:Diverticulum / Q000150:complications / Q000601:surgery*; D004378:Duodenal Diseases / Q000150:complications / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*