Enteroscopic Diagnosis and Management of Small Bowel Diverticular Hemorrhage: A Multicenter Report from the Taiwan Association for the Study of Small Intestinal Diseases.
Small bowel diverticulum is a rare cause of gastrointestinal bleeding. The diagnosis and treatment of small bowel diverticular hemorrhage is clinically challenging before the development of deep enteroscopy. In this multicenter study from the Taiwan Association for the Study of Small Intestinal Diseases (TASSID), 608 patients underwent deep enteroscopy for obscure gastrointestinal bleeding during January 2004 and April 2010 from eight medical centers in Taiwan. Small bowel diverticular hemorrhage account for 7.89% of obscure gastrointestinal bleeding in this study. Most of the patients received endoscopic therapy with an initial hemostasis rate of 85.71% and rebleeding rate of 20%. In this large case series investigating the enteroscopic management of small intestinal diverticular hemorrhage, we found that, as to patients with peptic ulcer hemorrhage, most of these patients can be successfully managed by endoscopic therapy before surgery in the era of deep enteroscopy.
Division of Gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan ; Endoscopy Center, Department of Gastroenterology, Changhua Christian Hospital, Changhua 50000, Taiwan.
Yang-Yuan
YY
Chen
Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 33344, Taiwan.
Cheng-Tang
CT
Chiu
Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 33344, Taiwan.
Chen-Ming
CM
Hsu
Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 33344, Taiwan.
Tsung-Hsing
TH
Chen
Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Yi-Chun
YC
Chiu
Department of Gastroenterology, Buddhist Taichung Tzu Chi Hospital, Taichung 42700, Taiwan.
Yen-Chang
YC
Chu
Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan.
Chen-Wang
CW
Chang
Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan.
Hsiu-Po
HP
Wang
Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80700, Taiwan.
Deng-Chyang
DC
Wu
Division of Gastroenterology, Tri-Service General Hospital, Taipei 11400, Taiwan.
Tien-Yu
TY
Huang
Endoscopy Center, Department of Gastroenterology, Changhua Christian Hospital, Changhua 50000, Taiwan.
Hsu-Heng
HH
Yen