Complicated small-bowel diverticulosis and the role of Acute Care for the Elderly Unit

Small-bowel diverticulosis is a rare condition that occurs in older adults. Patients are usually asymptomatic, and some will develop complications such as gastrointestinal (GI) bleeding, intestinal obstruction, diverticulitis, and perforation. This is the case of a 95-year-old male patient with a previous history of heart failure with a preserved ejection fraction of 55%–60% and aortic stenosis since October 2019, atrial fibrillation managed with a permanent pacemaker, oral anticoagulation treatment (which was discontinued due to GI bleeding), hypertension, hypothyroidism, and chronic kidney disease. The patient presented with melena and was diagnosed with upper GI bleeding. The GI, general surgery, interventional radiology, geriatric, and palliative care teams were involved in his care. The patient received multiple blood transfusions, and upper and lower GI endoscopic and interventional radiological procedures were performed. However, owing to the patient’s functional status and age, surgery was not an option. The patient was referred to a palliative care team.