Small-Bowel Diverticulosis: Enteroscopic Diagnosis of an Unusual Cause of Overt Small Bowel Bleeding

An 89-year-old Caucasian man with atrial fibrillation undergoing treatment with rivaroxaban, presented with melena requiring daily blood transfusion. Laboratory parameters showed normocytic normochromic anemia (hemoglobin level, 7.5 g/dL) and normal coagulation (international normalized ratio, 1.17; activated partial thromboplastin time, 23.5 s). Previous esophagogastroduodenoscopies and ileocolonoscopy only showed blood in the terminal ileum. A videocapsule enteroscopy showed dark-red blood arising from the proximal jejunum without identifiable lesions.

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