title: Risk factors for early rebleeding after endoscopic band ligation for colonic diverticular hemorrhage.
abstract: OBJECTIVE
  Endoscopic band ligation (EBL) has been used for hemostasis of colonic diverticular hemorrhage. However, early rebleeding (< 30 days after EBL) has been reported in some cases. The aim of this study was to elucidate risk factors for early rebleeding after EBL in treatment of colonic diverticular hemorrhage.
  
  
  METHODS
  A total of 101 patients with definite diverticular hemorrhage treated using EBL from June 2009 to October 2014 were included in the retrospective cohort study and divided into rebleeding and non-rebleeding groups, depending on the presence or absence of early rebleeding. Patients' ages, comorbid diseases, stigmata of recent hemorrhage (SRH) [active bleeding (AB), non-bleeding visible vessel (NBVV), or adherent clot (AC)], locations of bleeding diverticula, and eversions of the diverticula after EBL were retrospectively evaluated in each group.
  
  
  RESULTS
  Early rebleeding occurred in 15 cases. The median time (range) of early rebleeding occurrence was 5 days (range, 2 h to 26 days). Early rebleeding could be managed conservatively and/or endoscopically, except in one case in which surgery was done. Multivariate analysis revealed that age under 50 (adjusted OR, 8.7; 95 % CI 1.6 - 52.5; P = 0.014) and AB (adjusted OR, 4.21; 95 % CI 1.15 - 18.1; P = 0.03) were shown to be significant risk factors. The right side of the colon carried less risk than did the left side (adjusted OR, 0.21; 95 % CI 0.04 - 0.84; P = 0.028).
  
  
  CONCLUSIONS
  Younger age, AB of SRH, and leftsided lesions were identified as the risk factors for early rebleeding after EBL in the treatment of colonic diverticular hemorrhage.
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ikeya
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Nakano
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Omata
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Yuto
authors.initials: Y
authors.lastname: Shimamura
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Mai
authors.initials: M
authors.lastname: Ego
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Takagi
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Fujita