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Korean J Intern Med > Volume 35(1); 2020 > Article
Ohira, Iraha, Kinjo, Hokama, and Fujita: Jejunal diverticulosis
An 82-year-old female presented with melena. She had been on thrice-weekly conventional hemodialysis for 8 years. An esophagogastroduodenosopy and colonoscopy revealed no bleeding source. A small bowel series revealed multiple round-shaped jejunal diverticula (Fig. 1) and balloon enteroscopy confirmed large diverticula in the jejunum (Fig. 2). Diverticular bleeding was clinically suspected despite the absence of bleeding stigmata and she improved conservatively.
Symptomatic jejunal diverticular diseases including bleeding and diverticulitis are extremely rare. Recently, balloon enteroscopy has been established as a safe and effective modality to detect and treat jejunal diverticular bleeding. When a bleeding diverticulum is identified, bleeding can be managed with endoscopic clipping or injection therapy. Angiography is also useful for the diagnosis and treatment. In cases of failure of endoscopic and angiographic management, surgical intervention should be considered.
Informed consent was obtained.

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figure 1.
A small bowel series showing jejunal diverticulosis.
kjim-2018-219f1.jpg
Figure 2.
(A) Balloon enteroscopy reveling large diverticula in the jejunum. (B) The intestinal lumen (the left side) had Kerckring folds. (C) The vessels were shown inside the diverticulum. (D) The closer observation revealed intramucosal bold vessels on the diverticular base.
kjim-2018-219f2.jpg
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