Bulbar Diverticulum: A Case Report

The duodenal bulbar diverticulum is a rare condition characterized by the protrusion of the mucosa through the muscular wall of the duodenal bulb. Typically asymptomatic, it is often discovered incidentally during endoscopic or imaging examinations. This article reports the case of a 65-year-old patient admitted for isolated episodes of hematemesis. Upper gastrointestinal endoscopy revealed multiple diverticula on the posterior wall of the duodenal bulb, associated with signs of chronic inflammation but no active bleeding. Management consisted of proton pump inhibitor (PPI) treatment combined with clinical and endoscopic monitoring. The outcome was favorable, with no recurrence of bleeding after one year of follow-up. Bulbar diverticula are rare, accounting for approximately 2–5% of duodenal diverticula. Their development is associated with factors such as advanced age, a high-fiber diet, and, occasionally, congenital abnormalities. While generally asymptomatic, they can cause abdominal pain, digestive disorders, or, in rare cases, bleeding. Management depends on the severity of symptoms, ranging from simple monitoring to endoscopic or surgical interventions in complicated cases. This case highlights the importance of including bulbar diverticula in the differential diagnosis of gastrointestinal bleeding and demonstrates the effectiveness of conservative management in uncomplicated cases.