ABSTRACT
Duodenal diverticulum appears in 6% of upper gastrointestinal examinations and up to 23% of endoscopic retrograde cholangiopancreaticographies and up to 22% at autopsy. Most of these patients are asymptomatic, but a small fraction develop complications including choledocholithiasis, cholangitis, pancreatitis, diverticulitis, perforation, fistular formation and bleeding. Among these complications, only a few documented cases of bleeding have been reported in the literature, and the experience of endoscopist to the sequence of diagnosis, endoscopic treatment, and subsequent relief of the symptoms remains limited. Aggressive but careful endoscopic examination can help diagnosis of the cases. Also, endoscopic treatment of duodenal diverticular bleeding is very effective and proved to be an effective alternative to surgery. We report 4 patients with duodenal diverticular bleeding in whom both diagnosis and definitive treatment were successful by endoscopy alone.