We report the case of an 80-year-old woman who came to the emergency department with a four-day history of asthenia, melenic stools, and then free rectal bleeding, together with vomiting in coffee grounds.
The patient denied taking gastro-intestinal drugs.
During her stay in the emergency room she experienced an episode of hypotension.
An urgent blood test showed anemia (Hb: 7 g/dl), requiring transfusion of two units of catheters.
Given the clinical picture, an urgent gastroscopy showed reduced remnants in the gastric chamber.
Upon passing to the bulb and second portion of the duodenum, fresh frozen remains were observed.
After a profuse lavage, a duodenal diverticulum was identified distally to the papilla, in which drooling bleeding was observed.
With some difficulty due to the gastrium instability, there was consolidation 4 cc cc.
After 24 hours, the patient again had an episode of hypotension and the laboratory test showed new anemization (Hb: 6.5 g/dl), so it was decided to perform a new urgent endoscopy.
Gastroenteritis was advanced to a well-known diverticulum. This time, with better accessibility and stability, another 4 ccs of colitis were established.
There was still minimal bleeding, so it was decided to coagulate the vascular lesion with argon gas.
After this therapy, and after transfusion of two new concentrates, the patient remained stable and did not repeat new bleeding episodes, so she was discharged after five days.
He has not repeated bleeding episodes again in three months of follow-up.
