A CASE OF MASSIVE BLEEDING FROM A DUODENAL DIVERTICULUM IN THE 3RD PORTION SUCCESSFULLY TREATED WITH TRANSCATHETER ARTERIAL EMBOLIZATION

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  • 動脈塞栓術にて救命した十二指腸水平部憩室大量出血の１例

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Abstract

Bleeding from diverticula of the duodenum is rare and difficult to be diagnosed. This is a rare case which showed the usefulness of angiography in diagnosis of bleeding from a duodenal diverticulum.<BR>A 64-year-old man was brought into our department by ambulance because of an abrupt episode of massive melena. Despite an endoscopy at another hospital, the origin of bleeding could not be identified in the stomach, duodenum, and colon. A repeated endoscopy revealed acute bleeding from the eroded mucosa in a duodenal diverticulum in the 3rd portion. Endoscopic clipping was unsuccessful. Emergency angiography disclosed extravasation of the contrast material from a branch of the inferior pancreaticoduodenal artery, and then hemostasis was made by embolization with coils. The patient was discharged from the hospital on the 11th postoperative day. Rebleeding has not occurred.

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