Multiple duodeno-jejunal diverticula causing massive intestinal bleeding

A case of massive intestinal blood loss from multiple duodeno-jejunal diver ticula is described. A 39-year-old man was referred to our hospital because of recurrent bloody stool and worsening anemia. Upper and lower endoscopy, selective abdominal angiography, and radionuclide scanning were performed to seek the cause of the intestinal bleeding, but none of these studies rev ealed the source of bleeding. Small-bowel barium follow-through examination showed numerous diverticula in the distal duodenum and proximal jejunum. E xcision of the duodenal diverticulum and resection of the involved portion of the jejunum cured the patient. On histopathological examination, an ulce rative lesion with:an exposed vessel suggestive of the source of bleeding w as seen in the resected duodenal diverticulum. Although duodeno-jejunal div erticula are rare, the importance of a careful search for this malformation in a patient with intestinal blood loss is stressed.