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Diagnostic and Therapeutic Endoscopy
Volume 2008, Article ID 156496, 3 pages
http://dx.doi.org/10.1155/2008/156496
Case Report

Bleeding Jejunal Diverticulosis in a Patient with Myasthenia Gravis

Department of Internal Medicine I, School of Medicine, University of Regensburg, 93042 Regensburg, Germany

Received 1 September 2007; Revised 14 November 2007; Accepted 24 January 2008

Academic Editor: Avraam Ploumis

Copyright © 2008 I. Zuber-Jerger et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A seventy-year-old male presented with severe myasthenia gravis and an episode of obscure bleeding. There was a history of gastric ulcer leading to Billroth II surgery twenty-five years ago. Upper endoscopy revealed no pathology. Colonoscopy showed a few solitary diverticula and traces of old blood in the terminal ileum. Capsule endoscopy pictured red smear in the upper jejunum. Diverticula were seen as well. Suspecting bleeding jejunal diverticulosis double balloon enteroscopy was performed. The complete jejunal ascending loop and about 100 cm of the jejunum through the descending jejunal loop could be inspected. Large diverticula with fecoliths were found in both loops. Bleeding had ceased. The patient was discharged to neurology for optimizing therapy for myasthenia gravis.