title: Colonoscopic treatment of acute diverticular hemorrhage using endoclips.
abstract: Although colonoscopy is used in the diagnostic evaluation of patients with diverticular hemorrhage, data on colonoscopic treatment outcomes are limited. We reviewed records of inpatients undergoing colonoscopy to identify patients that were colonoscopically diagnosed and treated for acute diverticular hemorrhage. Eleven patients with acute diverticular hemorrhage had active bleeding (n = 7) or non-bleeding visible vessel (n = 4) at colonoscopy. Endoclip treatment (preceded by epinephrine injection in 64%) achieved hemostasis in all patients without procedural complications. Patients were discharged within three days without evidence of early rebleeding. During a median follow-up of 15 months, late recurrent bleeding occurred in two patients (18.2%). Colonoscopic treatment of patients with acute diverticular hemorrhage using endoclips appears to be effective and safe, with high rates of immediate and long-term success. Colonoscopy should be considered in patients with suspected acute diverticular hemorrhage, as it may enable definitive therapy without the need for more invasive treatment.
authors.affiliation: Division of Gastroenterology, University of California, San Francisco, CA, USA.
authors.forename: Eugene F
authors.initials: EF
authors.lastname: Yen
authors.forename: Uri
authors.initials: U
authors.lastname: Ladabaum
authors.forename: V Raman
authors.initials: VR
authors.lastname: Muthusamy
authors.forename: John P
authors.initials: JP
authors.lastname: Cello
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: McQuaid
authors.forename: Janak N
authors.initials: JN
authors.lastname: Shah
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000379:methods*; D004241:Diverticulum, Colon / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000601:surgery*; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000009:adverse effects; D016896:Treatment Outcome