Background: Hemorrhagic shock from multiple duodenojejunal diverticular bleeding has rarely been reported in the literature. Case Report: A 75-year-old male was admitted with symptoms of syncope and melena persisting for 1 day. During hospitalization, massive melena and hematochezia were noted with episodes of shock. Upper gastrointestinal pan-endoscopy, colonoscopy and angiography failed to identify the source of bleeding. A technetium-labeled erythrocyte scintigraphy suggested proximal intestinal hemorrhage. Additionally, barium examination of the small intestine revealed diverticulosis over the 4th portion of the duodenum and the proximal jejunum. Surgical intervention with resection of the diverticula cured the patient. Conclusion: Although shock from multiple duodenojejunal diverticular bleeding is rare, this possibility should be considered in patients with gastrointestinal bleeding. © 2007 S. Karger GmbH.