title: Effectiveness of therapeutic barium enema for diverticular hemorrhage.
abstract: OBJECTIVE
  To evaluate the effectiveness of barium impaction therapy for patients with colonic diverticular bleeding.
  
  
  METHODS
  We reviewed the clinical charts of patients in whom therapeutic barium enema was performed for the control of diverticular bleeding between August 2010 and March 2012 at Yokohama Rosai Hospital. Twenty patients were included in the review, consisting of 14 men and 6 women. The median age of the patients was 73.5 years. The duration of the follow-up period ranged from 1 to 19 mo (median: 9.8 mo). Among the 20 patients were 11 patients who required the procedure for re-bleeding during hospitalization, 6 patients who required it for re-bleeding that developed after the patient left the hospital, and 3 patients who required the procedure for the prevention of re-bleeding. Barium (concentration: 150 w%/v%) was administered per the rectum, and the leading edge of the contrast medium was followed up to the cecum by fluoroscopy. After confirmation that the ascending colon and cecum were filled with barium, the enema tube was withdrawn, and the patient's position was changed every 20 min for 3 h.
  
  
  RESULTS
  Twelve patients remained free of re-bleeding during the follow-up period (range: 1-19 mo) after the therapeutic barium enema, including 9 men and 3 women with a median age of 72.0 years. Re-bleeding occurred in 8 patients including 5 men and 3 women with a median age of 68.5 years: 4 developed early re-bleeding, defined as re-bleeding that occurs within one week after the procedure, and the remaining 4 developed late re-bleeding. The DFI (disease-free interval) decreased 0.4 for 12 mo. Only one patient developed a complication from therapeutic barium enema (colonic perforation).
  
  
  CONCLUSIONS
  Therapeutic barium enema is effective for the control of diverticular hemorrhage in cases where the active bleeding site cannot be identified by colonoscopy.
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Mizue
authors.initials: M
authors.lastname: Matsuura
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inamori
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Komiya
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Inoh
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Kawasima
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Naitoh
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Eduka
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kanazawa
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Shiori
authors.initials: S
authors.lastname: Uchiyama
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Tani
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Kennichi
authors.initials: K
authors.lastname: Kawana
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Setsuya
authors.initials: S
authors.lastname: Ohtani
authors.affiliation: Mizue Matsuura, Masahiko Inamori, Atsushi Nakajima, Hepatology and Gastroenterology, Yokohama City University Hospital, Yokohama 236-0004, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Nagase
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate / Q000008:administration & dosage*; D003287:Contrast Media / Q000008:administration & dosage*; D004241:Diverticulum, Colon / Q000150:complications* / Q000175:diagnosis; D004733:Enema; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011859:Radiography; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate
keywords: Barium enema; Barium impaction; Diverticular hemorrhage; Non-steroidal antiinflammatory drugs; Re-bleeding