Active gastrointestinal diverticulum bleeding diagnosed by computed tomography angiography

Abstract

A diverticulum is a bulging sack in any portion of the gastrointestinal tract. Small intestine diverticular disease is much less common than colonic diverticular disease. The most common symptoms include non-specific epigastric pain and a bloating sensation. Major complications include diverticulitis, gastrointestinal bleeding, acute perforation, intestinal obstruction, intestinal perforation, localized abscess, malabsorption, anemia, volvulus and bacterial overgrowth. We report one case of massive jejunal diverticula bleeding and one case of massive colonic diverticula bleeding, both diagnosed by acute abdominal computed tomography angiography and treated successfully by surgery.

Digestive bleeding due to jejunal diverticula: diagnosis and management

“…We reviewed the literature and found case reports of jejunal diverticular haemorrhage (table 1). 14–23…”

“…However, further research is needed given the location of the bleeding site, which is beyond the reach of these procedures. Many modalities have been introduced to evaluate gastrointestinal diverticular bleeding, including barium contrast study, Technetium 99m (99mTc), red blood cell scan, CT scan, angiography, CT angiography, capsule endoscopy, etc 11 15 16 24…”

“…Although it may show small bowel diverticula clearly, it is not sensitive enough to detect haemorrhagic lesions. CT angiography is commonly used for jejunal diverticular haemorrhage diagnosis, with a pooled sensitivity of 86% and specificity of 95% in acute GI bleeding 15 16…”

Hemorragia gastrointestinal por diverticulosis yeyunal una complicación infrecuente: reporte de un caso

“…La angiotomografía abdominal se considera el método diagnóstico de primera línea en un paciente con sospecha de sangrado procedente del intestino delgado, debido a que permite visualizar la presencia o ausencia de extravasación del material de contraste en la luz intestinal; tiene una sensibilidad del 86% y especificidad del 95% para el diagnóstico de hemorragia digestiva aguda (20) .…”

The Impacts of Arctic Passages Opening on China's International Shipping

“…The form to reach the trade in goods is giving priority to container shipping. In 2013, Asia and Europe's seaborne volume of container had reached 19.846 million TEU [3]. The Arctic navigation has an important influence on ship routes.…”