(Disclaimer: This article is for scientific purposes only, in order to protect the privacy of patients, the relevant information in the following content has been processed) Abstract: A 74-year-old man came to the clinic because of the presence of black stools without any triggers, soft stools, moderate amount, accompanied by nausea, vomiting with blood and other discomforts, and in order to make a definitive diagnosis, barium translucency of the gastrointestinal examination was performed, and the presence of duodenal diverticulum was detected. Therefore, according to the patient’s specific situation, medication was given, such as oral esomeprazole magnesium enteric-coated tablets, magnesium aluminum carbonate suspension, atorvastatin calcium tablets, and eventually the patient’s symptoms were relieved. Basic information] Male, 74 years old [Disease type] Duodenal diverticulum [Consultation hospital] The First Affiliated Hospital of Chongqing Medical University [Consultation time] January 2022 [Treatment plan] Oral medication (esomeprazole magnesium enteric-coated tablets, magnesium alumina carbonate suspension, atorvastatin calcium tablets) [Treatment cycle] Hospitalization for 7 days [Treatment effect] Patient’s symptoms relieved I. Initial interview The patient is 74 years old. The patient is a 74-year-old male, who reported that yesterday he had black stools for one time without any cause, soft stools, moderate amount, accompanied by nausea, vomiting with fresh blood and other discomforts, but did not have dizziness, fatigue, palpitations, sweating, diarrhea, bloating, acid reflux, belching, chest tightness, chest pain, cough, cough sputum, chills, fever and other symptoms, in order to make a definitive diagnosis, and so he went to the hospital for medical consultation. Further communication with the patient to understand the patient’s morbidity, we learned that the patient’s spirit, appetite, sleep worse than before, black stools, but normal urine. The patient had no history of chronic gastritis, peptic ulcer, or family history of the disease, but there was a history of smoking and alcohol consumption, and he was admitted to the hospital with “black stools and vomit with blood, to be investigated”. The patient was admitted to the hospital and was given a physical examination. The general examination showed a temperature of 36.5°C, pulse of 73 beats/min, respiration of 19 breaths/min, blood pressure of 131/76 mmHg, clear consciousness, no abnormalities of the skin and mucous membranes of the whole body, and no palpable lymph nodes were enlarged. On auscultation, the patient’s respiratory sounds were clear, no dry or wet rales were detected, the heart rhythm was unchanged, and no murmurs or pericardial friction sounds were heard on cardiac auscultation. On palpation, the abdomen was flat and soft, with no pressure or rebound pain, negative mobile turbidities, 3 bowel sounds/min, and no abnormalities in the external genitalia. In order to further clarify the diagnosis and cause of the disease, the patient was given a barium gastrointestinal examination, which showed no obvious active and substantial lesions in both lungs and no obvious abnormalities in the esophagus, but a duodenal diverticulum was found, so the ultrasound was reviewed and the patient was diagnosed with duodenal diverticulum, which was the cause of the patient’s black stools, vomiting blood and other symptoms. After clarifying the cause of the disease, the patient was given medication, including oral omeprazole magnesium enteric-coated tablets to inhibit acidity, magnesium aluminum carbonate suspension to protect the gastric mucosa, and atorvastatin calcium tablets to regulate lipids, and other comprehensive treatments. (The arrow is the duodenal diverticulum site) Third, the treatment effect 3 days of medication, the patient patient nausea, vomiting with blood and other symptoms of discomfort significantly relieved, did not appear abdominal pain, abdominal distension, fever, 7 days of medication, the patient nausea, vomiting with blood, black stools and other symptoms completely disappeared, during the period of time, did not reoccur abdominal pain, abdominal distension, fever and other symptoms. The patient was examined again, the patient’s body temperature was 36.6℃, pulse was 77 times/min, respiration was 19 times/min, blood pressure was 121/69mmHg, the voice was clear, the conjunctiva and lips were not pale, the breath sounds of both lungs were clear on auscultation, and there were no obvious dry and wet rales, the heart rhythm was neat, and the abdomen was soft on palpation, with no compression pain, muscle tension, rebound pain, and the spleen was not touched under the ribs. No other abnormalities were found in other auxiliary examinations, and the patient was discharged from the hospital with the consent of the hospital. IV. Precautions We are glad that the patient’s condition has improved after treatment, but it does not mean that it can be solved once and for all, and the patient still needs to pay attention to the following points after being discharged from the hospital: 1. In terms of diet, focus on light, easy to digest, and eat more fresh vegetables and fruits, and avoid eating overly hot, too hard diets, such as hot pots, baklava, and so on, and at the same time, avoid drinking alcohol, and ingesting stimulating drinks, such as coffee, cola, etc. At the same time, eat regularly, and avoid overeating, so that the patient can have more than one meal. At the same time, regular diet, avoid overeating; 2, in life, the patient can according to their own situation appropriate exercise, such as jogging, swimming, etc., at the same time, pay attention to review, if abdominal pain, abdominal distension and other symptoms of discomfort, timely consultation. V. Personal perception Duodenal diverticulum in the clinical general no special symptoms, only a small number of patients will appear abdominal distension, abdominal pain and other discomforts, may also appear nausea, vomiting and other symptoms, but because of its atypical symptoms, it is often easy to be ignored and misdiagnosed. In this case, the patient was found to have the disease only when he underwent a barium gastrointestinal examination, which also illustrates the insidious nature of the disease. In clinical practice, regular medical checkups are recommended for the elderly, and the patient in this case stabilized his condition with medication alone due to timely consultation. For gastrointestinal bleeding, gastroenteroscopy should be performed if the patient’s vital signs are stable. In addition to identifying the cause of the disease, direct hemostasis under the microscope can be performed, which is more effective.