Effectiveness of high-dose barium enema filling for colonic diverticular bleeding.
OBJECTIVE
Therapeutic barium enema was first reported in 1970. The long-term recurrence rate of colonic diverticular bleeding after therapeutic barium enema was compared with that of endoscopic haemostasis.


METHODS
This study included 57 consecutive patients admitted between 2003 and 2008 with colonic diverticular bleeding in whom conservative treatment failed to stop bleeding within 3 h of hospital admission. Lower gastrointestinal endoscopy was performed immediately after admission. In 75% of patients, bleeding was from the right colon, and any identifiable source of bleeding was treated by endoscopic haemostasis. Cases with an undetectable source received high-dose barium impaction therapy.


RESULTS
Treatment was as follows: Group A (n = 37) solely by endoscopic haemostasis; Group B (n = 11) solely by therapeutic barium enema group, and Group C (n = 9) by endoscopic haemostasis and therapeutic barium enema. At a follow up of seven (median; range: 1-56) months, recurrent bleeding rates were 18/37 (48.6%), 6/11 (54.5%) and 2/9 (22.2%) (P = 0.3930).


CONCLUSIONS
High-dose barium enema is as effective as endoscopic haemostasis for the prevention of recurrent diverticular bleeding.
Fujimoto
A
A
Division of Gastroenterology, Department of Gastroenterology and Hepatology, Internal Medicine, Toho University Omori Medical Center, Tokyo, Japan. ai-fujimoto@med.toho-u.ac.jp
Sato
S
S
Kurakata
H
H
Nakano
S
S
Igarashi
Y
Y
D000368:Aged; D001466:Barium Sulfate / Q000008:administration & dosage*; D003108:Colonic Diseases / Q000150:complications* / Q000628:therapy; D004241:Diverticulum, Colon / Q000150:complications* / Q000628:therapy; D004733:Enema; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D016558:Hemostasis, Endoscopic; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence
D001466:Barium Sulfate