Endoscopic therapy for acute colonic diverticular bleeding: a multicenter study

D. M. McClendon, P. B. Cotton, H. Evangelou, J. G. Lee, J. W C Leung, S. M. Schutz, P. R. Storms, G. S. Young

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Abstract

Actively bleeding diverticula are rarely observed at colonoscopy and there are only anecdotal reports of various endoscopic treatments for these lesions. Our goal was to use our shared database to determine the frequency, methods, and outcome of endoscopic treatment for acute colonic diverticular bleeding. METHODS: GI-Trac database was used to review consecutive colonoscopies performed at each center. Patient records and endoscopy reports of patients who received endoscopic therapy for acute diverticular bleeding were reviewed to assess success and complication rates. RESULTS: Six of 4187 (0.14%) colonoscopies involved endoscopic treatment for acute diverticular hemorrhage. Active bleeding was observed in three of the six patients and was successfully treated in two with mucosal injections of 1:10,000 epinephrine solution and one with dilute epinephrine irrigation. One patient had no further bleeding and two who had a previous history of recurrent hemorrhage were stabilized prior to elective surgery. The remaining three patients had fresh clot observed overlying the rim of a diverticulum that was felt by the endoscopist to be the site of the hemorrhage. Two of three were treated with BICAP electrocautery, and one was treated with injection of epinephrine. Two had no further bleeding and one with a past history of recurrent hemorrhage rebled while awaiting elective resection. CONCLUSIONS: Endoscopic treatment of acute diverticular hemorrhage is infrequently performed, but appears to be safe and effective. This treatment may prevent surgery or allow for stabilization of a patient for whom elective surgical treatment is planned.

Original languageEnglish (US)
JournalGastrointestinal Endoscopy
Volume45
Issue number4
StatePublished - 1997

ASJC Scopus subject areas

  • Gastroenterology

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    McClendon, D. M., Cotton, P. B., Evangelou, H., Lee, J. G., Leung, J. W. C., Schutz, S. M., Storms, P. R., & Young, G. S. (1997). Endoscopic therapy for acute colonic diverticular bleeding: a multicenter study. Gastrointestinal Endoscopy, 45(4).