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An uncommon source of upper gastrointestinal bleeding: epiphrenic esophageal diverticulum.

著者 Tse CS , Parikh ND
Gastroenterol Rep (Oxf).2017 11 ; 5(4):313-315.
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Esophageal diverticula are rare findings that have an estimated incidence of 1 per 500 000 people per year, even though acute upper gastrointestinal bleeding is a relatively common medical emergency with an incidence of up to 150 per 100 000 people per year and a mortality rate of 7-14%. An 83-year-old man presented with hematemesis and melena. Urgent upper endoscopy revealed an esophageal diverticulum, within which was an adherent clot. Removal of the clot identified a bleeding vessel within the diverticulum; this was successfully clipped and hemostasis was achieved. To the best of our knowledge, this is the first case report of a bleeding epiphrenic esophageal diverticulum that was successfully managed endoscopically with hemostatic clips alone. While rare, our case serves as a reminder that bleeding epiphrenic esophageal diverticula can present as massive upper gastrointestinal bleeding and urgent endoscopic therapy can be life-saving.
PMID: 26304469 [PubMed]
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