[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-438417-105":59,"doc-detail-438417-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","jejunal-diverticular-hemorrhage-a-diagnostic-blind-spot-in-small-bowel-bleeding","Jejunal Diverticular Hemorrhage: A Diagnostic Blind Spot in Small Bowel Bleeding","","Small bowel bleeding is an uncommon but important cause of gastrointestinal hemorrhage. An 82-year-old woman presented with lightheadedness and diarrhea, and clinicians suspected a small-intestine source. Despite multiple evaluations, including two computed tomography angiograms and mesenteric arteriography, localization remained difficult. Continued clinical deterioration prompted surgical exploration, which identified and led to resection of a bleeding jejunal diverticulum, underscoring diagnostic blind spots in distal small bowel bleeding.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/jejunal-diverticular-hemorrhage-a-diagnostic-blind-spot-in-small-bowel-bleeding/438417/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/jejunal-diverticular-hemorrhage-a-diagnostic-blind-spot-in-small-bowel-bleeding/438417.png","ImageObject",300,407,{"name":92,"@type":93},"pixelkiddo","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is diagnosing small bowel bleeding difficult in this case?","Question",{"text":112,"@type":113},"Diagnosis was challenging due to limited endoscopic access, intermittent bleeding, and the length of the bowel, which can leave active bleeding undetected during standard evaluations.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What imaging studies were used before surgery?",{"text":117,"@type":113},"The team performed two computed tomography angiograms and subsequent mesenteric arteriography, and an emergent repeat CTA showed active extravasation from a presumed jejunal diverticulum.",{"name":119,"@type":110,"acceptedAnswer":120},"What ultimately confirmed and treated the bleeding source?",{"text":121,"@type":113},"Exploratory laparotomy was pursued after clinical deterioration; transillumination identified a bleeding jejunal diverticulum, leading to segmental small bowel resection.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},438417,1790740750,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},962090883892,"https://ap-avatar.wpscdn.com/avatar/e00115db34f3e0f11b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1790152879550218658","Review began 11/24/2025  \nReview ended 12/02/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nBakshi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98585  \nOpen Access Case Report  \nJejunal Diverticular Hemorrhage: A Diagnostic Blind Spot in Small Bowel Bleeding  \nNika Bakshi 1, Claire Wang 1 , Samiksha Pandey 2, Jimmi Mangla 3 , Michael Duffy 4  \n1. Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, USA 2. Gastroenterology, Corewell Health William Beaumont University Hospital, Royal Oak, USA 3. General Surgery, Corewell Health William Beaumont University Hospital, Royal Oak, USA 4. Gastroenterology and Hepatology, Corewell Health William Beaumont University Hospital, Royal Oak, USA  \nCorresponding author: Nika Bakshi, [nbakshi@oakland.edu](nbakshi@oakland.edu)  \nAbstract  \nSmall bowel bleeding is an uncommon but important cause of gastrointestinal (GI) hemorrhage. Here, we present a case of an 82-year-old woman who presented to the emergency department with lightheadedness and diarrhea. Upon further evaluation, a small-intestine bleed was suspected. Despite multiple studies, including two computed tomography angiograms (CTA) and subsequent mesenteric arteriography, localizing the hemorrhage was challenging. Due to ongoing clinical deterioration, a decision was made to pursue surgical exploration, which ultimately resulted in resection of the bleeding jejunal diverticulum.  \nCategories: General Surgery, Anatomy, Gastroenterology  \nKeywords: general surgery, gi bleeding, jejunal diverticula, small bowel gi bleeding, small bowel hemorrhage  \nIntroduction  \nJejunal diverticula are rare outpouchings ofthe small intestine with an incidence between 0.06% and 1.5%  \n[1] . Notably, this incidence is likely higher since the majority of jejunal diverticula are asymptomatic, reported in up to 80% of cases [1,2] . If symptomatic, patients often experience symptoms such as bloating and epigastric pain [1] . They can also lead to serious complications such as gastrointestinal (GI) bleeding, perforation, and obstruction in 18% of cases [1-3]. Patients with gastrointestinal bleeding often do not display previous GI symptoms and often develop acute-onset hemorrhage, making early detection and timely intervention imperative [1] .  \nDiagnosing bleeding from the small intestine, especially the distal jejunum, is particularly challenging due to limited endoscopic access, intermittent bleeding, and the length of the bowel [4] . For example, in patients with gastrointestinal bleeding, approximately 5%-10% will remain undetected on standard endoscopic evaluation [4] . Modern imaging, such as computed tomography angiography (CTA) and CT enterography (CTE), can also be limited due to intermittent bleeding patterns and hemodynamic instability, or in patients with severe kidney impairment [4] .  \nIn this case report, we present a case of a massive jejunal diverticular bleed in an elderly patient whose bleeding remained undetected despite multimodal evaluation. This case highlights the diagnostic challenges of small bowel bleeding, and in particular, jejunal diverticular bleeding, and emphasizes the importance of urgent laparotomy in these cases.  \nCase Presentation  \nAn 82-year-old woman with a past medical history of type 2 diabetes mellitus, hypertension, and atrial fibrillation, not on anticoagulation, and with no prior gastrointestinal history, presented to the emergency department with lightheadedness and diarrhea. On arrival, the patient was hemodynamically stable andafebrile. Her laboratory results were notable for iron deficiency anemia with a hemoglobin of 8 .5 g/dL (reference range: 12.1-15.0 g/dL) and hematocrit of 27.5%(reference range: 35.4%-44 .2%) . Upon further examination, dark maroo","cbCaii6M7SBK1Rcb","https://ap.wps.com/l/cbCaii6M7SBK1Rcb","pdf",2451534,"English","# Introduction\n## Case Presentation\n## Imaging and Diagnostic Evaluation\n## Intervention and Outcome","[{\"question\":\"Why is diagnosing small bowel bleeding difficult in this case?\",\"answer\":\"Diagnosis was challenging due to limited endoscopic access, intermittent bleeding, and the length of the bowel, which can leave active bleeding undetected during standard evaluations.\"},{\"question\":\"What imaging studies were used before surgery?\",\"answer\":\"The team performed two computed tomography angiograms and subsequent mesenteric arteriography, and an emergent repeat CTA showed active extravasation from a presumed jejunal diverticulum.\"},{\"question\":\"What ultimately confirmed and treated the bleeding source?\",\"answer\":\"Exploratory laparotomy was pursued after clinical deterioration; transillumination identified a bleeding jejunal diverticulum, leading to segmental small bowel resection.\"}]","Jejunal Diverticular Hemorrhage: A Diagnostic Blind Spot in Small Bowel Bleeding | PDF",1790685317,13]