Upper Digestive Bleeding due to Jejunal Diverticula

Abstract

Introduction: Upper gastrointestinal bleeding is a frequent disease in Cuba; therefore, knowledge about it, as well as its treatment, deserves special attention since its presentation is not quite common.

Objective: To present a patient with upper gastrointestinal bleeding due to jejunal diverticula from the fixed loop at Hospital Universitario Dr. Miguel Enríquez.

Case presentation: The case is presented of a 72-year-old female patient of mixed skin color, hypertensive, with a history of two previous cesarean sections, smoking and alcohol consumption, who comes to the emergency center with bloating and colicky abdominal pain accompanied by peritoneal reaction, anemia and leukocytosis. The condition improved with decompressive measures, but the peritoneal reaction persisted and diarrhea with bloody contents of high origin appeared; it was decided to perform emergency surgery with the diagnosis of acute mesenteric intestinal ischemia. In the surgical act, there was a diverticular disease starting in the fixed loop up to 50 cm of this, inflamed and with traces of bleeding. It was decided to resect the affected loop, and a mechanical anastomosis was performed at the level of the fixed loop. Satisfactory evolution and discharge after nine days.

Conclusions: Mechanical sutures in the high anastomosis of the first jejunal loops are the most recommended in this type of feared intestinal suture.