[Classification of the bleeding pattern in colonic diverticulum is useful to predict the risk of bleeding or re-bleeding after endoscopic treatment].

Abstract

We examined the re-bleeding rate after endoscopic hemostasis according to the bleeding pattern in patients with an acute lower gastrointestinal hemorrhage from colonic diverticula in 34 patients with active bleeding (Type 1) and 49 patients with exposed vessels and/or erosions in the base of diverticulum and no active bleeding (Type 2). Endoscopic hemostasis was performed by clipping the exposed vessel or erosions (direct method) or the entire diverticular orifice (reefing method). The incidence of re-bleeding was significantly higher in the Type 1 group than in the Type 2 group (p=0.002). All Type 1 cases were treated by the reefing method. In contrast, 14 of the 49 Type 2 cases were treated by the direct method, and no re-bleeding was observed in these cases. Of the other 35 Type 2 cases treated by reafing, rebleeding was seen in 5 cases. More effective endoscopic treatment is needed to prevent early re-bleeding, especially for Type 1 patients. The direct method may therefore reduce the rate of re-bleeding in Type 2 patients.

• Authors: Yoko Kominami, Hirotoki Ohe, Sayo Kobayashi, Reiji Higashi, Daisuke Uchida, Yuki Morimoto, Asuka Nakarai, Norifumi Numata, Ken Hirao, Tsuneyoshi Ogawa, Toru Ueki, Masahiro Nakagawa, Yasuyuki Araki, Motowo Mizuno, Kazuaki Chayama
• Journal: Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology (Nihon Shokakibyo Gakkai Zasshi) Vol. 109 Issue 3 Pg. 393-9 (Mar 2012) ISSN: 0446-6586 [Print] Japan
• PMID: 22398904 (Publication Type: English Abstract, Journal Article)

Topics

• Aged
• Colonoscopy
• Diverticulum, Colon (complications, pathology)
• Female
• Gastrointestinal Hemorrhage (pathology, therapy)
• Humans
• Male
• Recurrence