title: [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.affiliation: Department of Gastroenterology and Metabolism Graduate School of Biomedical Sciences, Hiroshima University Hospital, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kominami
authors.forename: Hirotoki
authors.initials: H
authors.lastname: Ohe
authors.forename: Sayo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Reiji
authors.initials: R
authors.lastname: Higashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Uchida
authors.forename: Yuki
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Asuka
authors.initials: A
authors.lastname: Nakarai
authors.forename: Norifumi
authors.initials: N
authors.lastname: Numata
authors.forename: Ken
authors.initials: K
authors.lastname: Hirao
authors.forename: Tsuneyoshi
authors.initials: T
authors.lastname: Ogawa
authors.forename: Toru
authors.initials: T
authors.lastname: Ueki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Araki
authors.forename: Motowo
authors.initials: M
authors.lastname: Mizuno
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000368:Aged; D003113:Colonoscopy; D004241:Diverticulum, Colon / Q000150:complications* / Q000473:pathology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D012008:Recurrence