Jejunal Diverticulosis Presenting as an Obscure Gastrointestinal Bleed—a Challenge in Diagnosis and Management

Obscure gastrointestinal bleeding is defined as persistent or recurrent bleeding without an obvious cause after endoscopic and radiological evaluation. Obscure gastrointestinal bleeding originates most commonly from the small intestine. Jejunal diverticulosis is an uncommon diagnosis in which multiple mucosal herniations are present in the mesenteric border of jejunum. There is always a delay in diagnosis as it is a rare clinical entity. This is a case report of a 35-year-old male who presented with overt gastrointestinal bleeding and was managed at another center with surgery and embolization. He was evaluated, and a bleeding jejunal diverticulum was identified as the source of bleed during on-table enteroscopy after exhausting other investigation modalities and having delay in definitive management due to difficulty in localizing the source of bleed. Awareness of jejunal diverticulosis and its complications is very important in obscure gastrointestinal hemorrhage to prevent the diagnostic delay. A stepwise approach is very important to identify the source of obscure gastrointestinal bleed.