Jejunal diverticula bleeding: A challenging diagnosis entity

Table 1 Bowel diverticular disease: Clinical overview

Study variable		Duodenum diverticula	Jejunum diverticula	Ileum diverticula	Colon diverticula
Epidemiology[14,19]	Prevalence	15%-42% (second most common in small bowel)	0.3%-2.3% (higher in Asia)	< 5% (usually jejunoileal)	30%-75% (most common worldwide)
	Age presentation	60-80 years old	Elderly patients	> 50 years old	> 60 years old
	Incidence	5%-10% (Western countries)	0.4%-4.6% (necropsy findings)	< 1%	10%-50%
Clinical presentation[29,37]		Upper GI bleeding; melena	Most commonly asymptomatic; bleeding, nausea, vomiting, diarrhea, vague abdominal pain	Hematochezia or melena	Hematochezia (90%); usually painless
Bleeding characteristics[30]		Usually mild to moderate	Often massive	Variable often self-limited	Most cases stop spontaneously
Diagnostic challenges[3]		Periampullary development	“Silent entity” if uncomplicated; Inaccessible through standard endoscopy	Site development	Intermittent bleeding
Endoscopic treatment[3,39]		60%-80% success rate	Enteroscopy useful in bleeding cases: If diagnosis is suspected	Limited data	Successful in 85%-95%
Re-bleeding rates[2]		20%-35% within 1 year	20% after initial endoscopic management	Limited data	10%-25% within 1 year

The epidemiology, clinical presentations, bleeding patterns, diagnostic challenges, and endoscopic management of diverticula throughout the gastrointestinal tract are described. Although jejunal diverticula are of low prevalence, they are of substantial clinical relevance due to their propensity for severe gastrointestinal bleeding and the diagnostic challenges related to their limited accessibility with conventional endoscopy. GI: Gastrointestinal.