title: Endoscopic band ligation for colonic diverticular hemorrhage.
abstract: BACKGROUND
  The number of sample cases of colonic diverticular hemorrhage treated with endoscopic band ligation (EBL) has been small to date.
  
  
  OBJECTIVE
  To elucidate the safety and efficacy of EBL for colonic diverticular hemorrhage.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  General hospital.
  
  
  METHODS
  A total of 29 patients with 31 colonic diverticula with stigmata of recent hemorrhage (SRH).
  
  
  METHODS
  Urgent colonoscopy was performed after bowel preparation. When diverticula with SRH were identified, marking with hemoclips was done near the diverticula. The endoscope was removed and reinserted after a band-ligator device was attached to the tip of endoscope. At first, EBL was attempted. In patients who could not be treated with EBL, epinephrine injection or endoscopic clipping was performed.
  
  
  METHODS
  Procedure time, rate of hemostasis and rebleeding, complications.
  
  
  RESULTS
  The mean procedure time was 47 ± 19 minutes. EBL was successfully completed in 27 colonic diverticula (87%); except in 3 diverticula with a small orifice and large dome and 1 diverticula in which the orifice was too large. Early rebleeding after EBL occurred in 3 of 27 cases (11%). Although 2 cases of sigmoid rebleeding could be managed by repeat EBL or conservatively, right hemicolectomy was performed in 1 ascending diverticulum, in which the bleeding source was not identified on repeat colonoscopy. Scar formation at previously banded diverticula was identified in 7 of 11 patients who underwent follow-up colonoscopy. There were no complications after EBL in any of the patients.
  
  
  CONCLUSIONS
  Retrospective study.
  
  
  CONCLUSIONS
  EBL is a safe and effective treatment for colonic diverticular hemorrhage, and colonic diverticula resolve after EBL.
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishii
authors.forename: Takeshi
authors.initials: T
authors.lastname: Setoyama
authors.forename: Gautam A
authors.initials: GA
authors.lastname: Deshpande
authors.forename: Fumio
authors.initials: F
authors.lastname: Omata
authors.forename: Michitaka
authors.initials: M
authors.lastname: Matsuda
authors.forename: Shoko
authors.initials: S
authors.lastname: Suzuki
authors.forename: Masayo
authors.initials: M
authors.lastname: Uemura
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Iizuka
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Fukuda
authors.forename: Koyu
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Fujita
mesh_terms: D000368:Aged; D003113:Colonoscopy; D004241:Diverticulum, Colon / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000009:adverse effects; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine