Brief Article
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World J Gastroenterol. Nov 28, 2010; 16(44): 5616-5620
Published online Nov 28, 2010. doi: 10.3748/wjg.v16.i44.5616
Application of double-balloon enteroscopy in jejunal diverticular bleeding
Tsung-Hsing Chen, Cheng-Tang Chiu, Wei-Pin Lin, Ming-Yao Su, Chen-Ming Hsu, Pang-Chi Chen
Tsung-Hsing Chen, Cheng-Tang Chiu, Wei-Pin Lin, Ming-Yao Su, Chen-Ming Hsu, Pang-Chi Chen, Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, China
Author contributions: Su MY designed the research; Chen TH, Lin WP and Su MY performed all the procedures; Hsu CM, Chiu CT and Chen PC provided the cases and suggestions; Chen TH wrote the paper.
Supported by Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital
Correspondence to: Ming-Yao Su, MD, Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 5, Fu-Hsin St., Kwei-Shan, Taoyuan 333, Taiwan, China. doctorsu@adm.cgmh.org.tw
Telephone: +886-3-3281200-8107 Fax: +886-3-3272236
Received: April 9, 2010
Revised: July 2, 2010
Accepted: July 9, 2010
Published online: November 28, 2010
Abstract

AIM: To evaluate the efficacy of endoscopic diagnosis and therapy for jejunal diverticular bleeding.

METHODS: From January 2004 to September 2009, 154 patients underwent double-balloon enteroscopy (DBE) for obscure gastrointestinal bleeding. Ten consecutive patients with jejunal diverticula (5 males and 5 females) at the age of 68.7 ± 2.1 years (range 19-95 years) at Chang Gung Memorial Hospital, Academic Tertiary Referral Center, were enrolled in this study.

RESULTS: Of the 10 patients, 5 had melena, 2 had hematochezia, 2 had both melena and hematochezia, 1 had anemia and dizziness. DBE revealed ulcers with stigmata of recent hemorrhage in 6 patients treated by injection of epinephrine diluted at 1:10 000, Dieulafoy-like lesions in 4 patients treated by deploying hemoclips on the vessels, colonic diverticula in 2 patients, and duodenal diverticula in 3 patients, respectively. Of the 2 patients who underwent surgical intervention, 1 had a large diverticulum and was referred by the surgeon for DBE, 1 received endoscopic therapy but failed due to massive bleeding. One patient had a second DBE for recurrent hemorrhage 7 mo later, which was successfully treated with a repeat endoscopy. The mean follow-up time of patients was 14.7 ± 7.8 mo.

CONCLUSION: DBE is a safe and effective treatment modality for jejunal diverticular bleeding.

Keywords: Double-balloon enteroscopy; Jejunal diverticular bleeding; Obscure gastrointestinal bleeding