Endoscopic Management of Jejunal Diverticular Bleeding: A Case Report and Systematic Review of the Literature.

Authors

Marta Pettinelli, Benedetto Neri, Dario Biasutto, Claudia Marinaccio, Giulia Parisi, Leandro Corradino, Margareth Martino, Francesco Maria Di Matteo

Published in

Case reports in gastrointestinal medicine. Volume 2026. Pages 1928370. Epub Aug 02, 2026.

Abstract

Bleeding from a jejunal diverticulum is a rare and potentially severe condition, challenging both to diagnose and to treat. We report the case of a 56-year-old woman presenting with massive melena, who initially underwent esophagogastroduodenoscopy (EGD) and abdominal angio-CT, both unable to identify the bleeding source. After negative urgent ileocolonoscopy, second-look EGD showed fresh blood in the distal duodenum with no potentially bleeding lesions. This observation prompted us to perform a push enteroscopy that revealed an ulcer with oozing bleeding from a vessel located on the neck of a jejunal diverticulum. Hemostasis was successfully achieved by the placement of 4 through-the-scope clips. Currently, device-assisted enteroscopy (DAE) is the standard technique for the treatment of most causes of small bowel bleeding. However, DAE is performed only by dedicated endoscopists, is not available on a large scale, and is time-consuming. The present case report suggests the possible role of push enteroscopy as both a diagnostic and therapeutic procedure in the presence of signs suggesting a proximal origin of small bowel bleeding. This technique may indeed avoid unnecessary delay in small bowel bleeding management.

PMID:
42548910
Bibliographic data and abstract were imported from PubMed on 04 Aug 2026.

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