MASSIVE UPPER GASTROINTESTINAL-BLEEDING ORIGINATING FROM A 4TH-STAGE DUODENAL DIVERTICULUM - A CASE-REPORT AND REVIEW OF THE LITERATURE

Duodenal diverticulum is well-known pathologic entity. Most such diver ticula are asymptomatic and located on the second state of the duodenu m. The diagnosis is most often established by endoscopy or upper gastr ointestinal radiography. Hemorrhage has been described but is an infre quent complication. We report on a patient who presented with massive upper gastrointestinal bleeding, originating from a fourth-stage duode nal diverticulum. The diagnosis was made with a combination of arterio graphy and scanning with technetium 99-labelled red cells. Diverticule ctomy was performed with a successful outcome. This report underlines the diagnostic limits of fiberoptic endoscopy for hemorrhagic lesions located past the third stage of the duodenum.