Hemorragia digestiva alta y divertículo duodenal. Reporte de un caso

• Published in: Acta gastroenterologica latinoamericana Vol. 50; no. 2
• Main Authors: Solé, Juan Jerónimo, Figgini, Hernán, Aloy, Leonela, Ritondale, Otto, Ruiz, Hugo Daniel
• Format: Journal Article
• Language: English
• Published: 28-06-2020
• ISSN: 2469-1119; 2469-1119
• DOI: 10.52787/PNLZ1760

Bleeding duodenal diverticulum is an infrequent pathology in need of emergency treatment due to its high mortality. We present the clinical case of a 72-year-old patient with multiple comorbidities, who was admitted with upper gastrointestinal bleeding, abdominal pain and hemodynamic instability. Once hemodynamic stability was achieved, upper digestive endoscopy was performed, showing duodenal diverticulum in the upper knee with bleeding in the fundus, performing hemostatic control. CT was requested: at the level of the upper duodenal knee, wide base diverticulum. Surgery was scheduled for the high risk of new bleeding. In surgery, cholecystectomy and diverticulectomy were performed laparoscopically with mechanical suture. Anatomopathological report: duodenal wall with parietal thinning of the duodenum, suggestive of diverticulum by pulsion. The discharge was granted with radiological control on the 3rd postoperative day. The aim of this case is to show the importance of endoscopic resolution of urgency and subsequent laparoscopic management in a patient with important risk factors, evidencing the short hospital stay without postoperative complications.