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This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery

Open Access Research article

Surgery for a gastric Dieulafoy’s lesion reveals an occult bleeding jejunal diverticulum. A case report

G Orlando3, IM Luppino1, R Gervasi3, MA Lerose3, B Amato2, R Spagnuolo1, R Marasco1, P Doldo1 and A Puzziello3*

Author Affiliations

1 Gastroenterology and Endoscopy Unit, T. Campanella Oncological Foundation, Catanzaro, Italy

2 General Surgery Unit, Dept of General Surgery, Geriatric and Endoscopy, University Federico II, Naples, Italy

3 Endocrine Surgery Unit, Department of Surgical and Medical Sciences, University Magna Graecia, Catanzaro, Italy

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BMC Surgery 2012, 12(Suppl 1):S29  doi:10.1186/1471-2482-12-S1-S29

Published: 15 November 2012

Abstract

Background

Jejunal diverticulosis is an uncommon disease and usually asymptomatic. It can be complicated not only by diverticulitis, but by hemorrhage, perforation, intussusception, volvulus, malabsorption and even small bowel obstruction due to enteroliths formed and expelled from these diverticula.

Methods

We describe a case of an occult bleeding jejunal diverticulum, casually discovered in a patient that was taken to surgery for a Dieulafoy’s lesion after unsuccessful endoscopic treatment. We performed a gastric resection together with an ileocecal resection.

Macroscopic and microscopic examinations confirmed the gastric Dieulafoy’s lesion and demonstrated the presence of another source of occult bleeding in asymptomatic jejunal diverticulum.

Discussion

The current case emphasizes that some gastrointestinal bleeding lesions, although rare, can be multiple and result in potentially life-threatening bleeding. The clinician must be mindful to the possibility of multisite lesions and to the correlation between results of the investigations and clinical condition of the bleeding patient.