Duodenal Diverticulum Co-Existing with a Bleeding Duodenal Ulcer: A Case Report

Abstract

Background: Duodenal diverticula are characterized by the presence of sac-like mucosal herniations through weak points in the duodenal wall. Duodenal diverticula co-existing with a bleeding duodenal ulcer is rare. Objective: The objective of this case report is to illustrate an uncommon case of two duodenal diverticula coexisting with duodenal ulcer.
Case report: A 40 year old Banker, who was previously well until about 10 days prior to presentation, when he developed epigastric pain and abdominal fullness. Five days later, he started passing melena stools. He had no vomiting, haematemesis or haematochezia. He had a history of consumption of caffeinated drinks and use of Nonsteroidal anti-inflammatory drugs (NSAIDS). He had upper gastrointestinal endoscopy, which revealed two duodenal diverticula and a duodenal ulcer measuring about 1cm by 1cm, with evidence of active bleeding located separately in the first part of the duodenum. He was managed with triple regimen of proton pump inhibitor for four weeks and two antibiotics for one week, following which his symptoms improved and no more passage of melena stools. A repeat endoscopy four weeks later showed the ulcer had healed. Conclusion: This reported case of duodenal diverticula co-existing with a bleeding duodenal ulcer is the first from Ilorin.

Keywords: Duodenal Diverticula, Bleeding, Duodenal Ulcer, Co-Existing