Identification of Small Bowel Diverticula with Double-Balloon Enteroscopy Following Non-diagnostic Capsule Endoscopy

Excerpt

An 87-year-old female with a history of myocardial infarction, cardiac stent placement, and atrial fibrillation on Plavix and Coumadin presented to the emergency room with shortness of breath and dyspnea on exertion for 2 weeks. The patient was found to have a hemoglobin of 8.4 g/dl, a drop of 3 g/dl from her baseline, and was heme positive on rectal examination. A colonoscopy and upper endoscopy were performed, which were remarkable for mild sigmoid diverticulosis. Capsule endoscopy revealed several red spots suspicious for AVMs without active bleeding. Double-balloon enteroscopy, which was performed for possible ablation of the AVMs, failed to identify vascular lesions. However, the DBE revealed numerous large duodenal and jejunal diverticula and no vascular lesions (Fig. 1).

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