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.
Highlights
Diverticulosis of the big bowel is a common disorder in elderly patients with a high percentage of clinical symptoms and complications
We present a case with extensive diverticulosis of the small bowel and discuss it in the light of recent literature
The patient suffered from a severe myasthenia gravis that was treated with pyridostigmine 360 mg
Summary
Diverticulosis of the big bowel is a common disorder in elderly patients with a high percentage of clinical symptoms and complications. Diverticulosis of the small bowel is considered a rare clinically silent disease. We present a case with extensive diverticulosis of the small bowel and discuss it in the light of recent literature
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