Diagnosis and treatment of diverticular hemorrhage in small intestine: A retrospective study

Arab J Gastroenterol. 2022 Aug;23(3):144-150. doi: 10.1016/j.ajg.2022.02.002. Epub 2022 Apr 23.

Abstract

Background and study aims: Small intestine diverticula are the most common cause of gastrointestinal hemorrhage, but prompt diagnosis remains challenging. Thus, this study aimed to identify strategies for the diagnosis and treatment of diverticular hemorrhage.

Patients and methods: Patients who presented with gastrointestinal tract bleeding to Guangzhou First People's Hospital between 2008 and 2014 were retrospectively examined. Gastrorrhagia and colonic hemorrhage were excluded based on the gastroscopy and colonoscopy findings, and the bleeding sites were in the small intestine. Data regarding patient characteristics, methods of diagnosis, treatment, and prognosis were collected.

Results: Eighty-five patients met the study criteria, and 45 patients were diagnosed with diverticular hemorrhage using double balloon enteroscopy, capsule endoscopy, computed tomography (CT), or digital subtraction angiography (DSA). Among these patients, 10 presented with massive bleeding and hemodynamic instability. All 45 patients underwent surgery and recovered with no complications, and all patients were followed-up for over 3 years, with no cases of recurrent hemorrhage.

Conclusion: Diverticular hemorrhage is the most common cause of small intestine bleeding. Double balloon enteroscopy, capsule endoscopy, CT, and DSA are effective methods for diagnosing small intestine diverticular hemorrhage. Surgical resection of the involved region is necessary and may achieve complete cure.

Keywords: Diagnosis; Diverticulum; Intestinal hemorrhage; Treatment.

MeSH terms

  • Diverticulum* / complications
  • Diverticulum* / diagnosis
  • Diverticulum* / surgery
  • Double-Balloon Enteroscopy / adverse effects
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy
  • Humans
  • Intestinal Diseases*
  • Intestine, Small / diagnostic imaging
  • Retrospective Studies