Classification of the bleeding pattern in colonic diverticulum is useful to predict the risk of bleeding or re-bleeding after endoscopic treatment

Yoko Kominami, Hirotoki Ohe, Sayo Kobayashi, Reiji Higashi, Daisuke Uchida, Yuki Morimoto, Asuka Nakarai, Norifumi Numata, Ken Hirao, Tsuneyoshi Ogawa, Toru Ueki, Masahiro Nakagawa, Yasuyuki Araki, Motowo Mizuno, Kazuaki Chayama

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

We examined the re-bleeding rate after endoscopic hemostasis according to the bleeding pattern in patients with an acute lower gastrointestinal hemorrhage from colonic diverticula in 34 patients with active bleeding (Type 1) and 49 patients with exposed vessels and/or erosions in the base of diverticulum and no active bleeding (Type 2). Endoscopic hemostasis was performed by clipping the exposed vessel or erosions (direct method) or the entire diverticular orifice (reefing method). The incidence of re-bleeding was significantly higher in the Type 1 group than in the Type 2 group (p = 0.002). All Type 1 cases were treated by the reefing method. In contrast, 14 of the 49 Type 2 cases were treated by the direct method, and no re-bleeding was observed in these cases. Of the other 35 Type 2 cases treated by reafing, rebleeding was seen in 5 cases. More effective endoscopic treatment is needed to prevent early re-bleeding, especially for Type 1 patients. The direct method may therefore reduce the rate of re-bleeding in Type 2 patients.

Original languageEnglish
Pages (from-to)393-399
Number of pages7
JournalJournal of Japanese Society of Gastroenterology
Volume109
Issue number3
Publication statusPublished - Mar 1 2012

    Fingerprint

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Kominami, Y., Ohe, H., Kobayashi, S., Higashi, R., Uchida, D., Morimoto, Y., Nakarai, A., Numata, N., Hirao, K., Ogawa, T., Ueki, T., Nakagawa, M., Araki, Y., Mizuno, M., & Chayama, K. (2012). Classification of the bleeding pattern in colonic diverticulum is useful to predict the risk of bleeding or re-bleeding after endoscopic treatment. Journal of Japanese Society of Gastroenterology, 109(3), 393-399.