{"title":"[Duodenal diverticular bleeding in a patient with situs inversus totalis: a case report].","authors":"Tasuku Nishitani, Tetsuya Segawa, Koki Tanaka, Tatsuya Matsuda, Machiko Okamoto, Yoshihiro Shimono, Tomohide Oyadomari, Nobumitsu Ryuge, Yoshinori Iwata, Akiyoshi Okada","doi":"10.11405/nisshoshi.122.782","DOIUrl":null,"url":null,"abstract":"<p><p>A 79-year-old female presented to the emergency department with complaints of abdominal pain and hematemesis/melena. Blood tests revealed anemia (hemoglobin:10.0g/dl). Abdominal plain computed tomography demonstrated situs inversus totalis and a cystic structure with high attenuation extending from the descending to the horizontal portion of the duodenum, suggesting duodenal diverticular bleeding. An emergency upper gastrointestinal endoscopy was performed, which revealed an exposed vessel in the descending part of the duodenum after the removal of blood clots. Hemostasis was successfully achieved using the endoscopic clipping method. This case highlights that even in patients with situs inversus totalis, where endoscopic manipulation can be difficult, careful technique modifications and procedural planning can facilitate successful endoscopic hemostasis.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 11","pages":"782-787"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Japanese Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.11405/nisshoshi.122.782","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
A 79-year-old female presented to the emergency department with complaints of abdominal pain and hematemesis/melena. Blood tests revealed anemia (hemoglobin:10.0g/dl). Abdominal plain computed tomography demonstrated situs inversus totalis and a cystic structure with high attenuation extending from the descending to the horizontal portion of the duodenum, suggesting duodenal diverticular bleeding. An emergency upper gastrointestinal endoscopy was performed, which revealed an exposed vessel in the descending part of the duodenum after the removal of blood clots. Hemostasis was successfully achieved using the endoscopic clipping method. This case highlights that even in patients with situs inversus totalis, where endoscopic manipulation can be difficult, careful technique modifications and procedural planning can facilitate successful endoscopic hemostasis.
期刊介绍：
The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.
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