title: Endoscopic detachable snare ligation: a new treatment method for colonic diverticular hemorrhage.
abstract: OBJECTIVE
  Colonic diverticular hemorrhage is the most common cause of lower intestinal bleeding. We tried to develop a convenient and reliable hemostatic method, endoscopic detachable snare ligation (EDSL), to treat diverticular hemorrhage and retrospectively explored its safety and efficacy.
  
  
  METHODS
  The definitive bleeding diverticulum was ligated with a detachable snare, instead of a rubber band, in a procedure similar to endoscopic band ligation. Removal of the scope to attach a ligation device and reinsertion for treatment are not needed in this method.
  
  
  RESULTS
  From November 2013 to September 2014, EDSL was used to treat 8 patients with colonic diverticular hemorrhage. The mean procedure time required for hemostasis after identification of the bleeding diverticulum was 5 ± 2 minutes. Sustained hemostasis was achieved in 7 patients (88 %), and early rebleeding occurred in 1 patient, in whom the applied suction seemed inadequate. No complications occurred in any patient.
  
  
  CONCLUSIONS
  EDSL may be a safe and effective treatment for colonic diverticular hemorrhage. However, additional studies are warranted to confirm these initial exploratory data.
authors.affiliation: Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Akutsu
authors.affiliation: Division of Endoscopy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Narasaka
authors.affiliation: Department of Gastroenterology, Koyama Memorial Hospital, Kashima, Ibaraki, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Wakayama
authors.affiliation: Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Terasaki
authors.affiliation: Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Matsui
authors.affiliation: Division of Endoscopy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Ichinosuke
authors.initials: I
authors.lastname: Hyodo
authors.affiliation: Division of Endoscopy, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizokami
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D004241:Diverticulum, Colon / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008026:Ligation / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome