846 How Often Do Patients Rebleed During Long-Term Follow-Up After An Initial Documented Diverticular Hemorrhage?

Jensen, Dennis M.; Singh, Bhavneet; Jensen, Mary E.; Sun, Na-Bo; Carrico, Martha

doi:10.1016/s0016-5085(08)60571-5

Cited by 6 publications

(7 citation statements)

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“…This range is quite wide, varying from 3.8%, reported by Poncet et al (17) in a French population, to 34.8%, presented by Nishikawa et al (23) in a group of Japanese patients. This may be explained by the use of different criteria for recurrence, different follow-up periods and diverse intrinsic characteristics of the populations studied, such as the presence of risk factors for rebleeding (2,7,12,17,(21)(22)(23). For instance, Okomoto et al (12) argue that the high bleeding recurrence rate reported in their study may be explained by the high proportion of patients in their population with arteriosclerosis-related diseases and anti-coagulant or non-steroidal anti-inflammatory drugs use, which they found to be risk factors for diverticular rebleeding.…”

Section: Discussionmentioning

confidence: 99%

“…With regard to the recurrence of CDB, available data points to rates between 3.8 and 34.8%, within the first year (2,7,12,17,(21)(22)(23). Although reports concerning the risk factors for rebleeding of colonic diverticula are scarce, old-er age, non-steroidal anti-inflammatory drugs, antiplatelet drugs, history of hypertension, peripheral vascular disease, renal deficiency, diverticulitis and shock at presentation have been associated with recurrence (12,(23)(24)(25)(26).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for severity and recurrence of colonic diverticular bleeding

Joaquim¹,

Caldeira²,

Antunes³

et al. 2016

Rev Esp Enferm Dig

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Background: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding. Risk factors related to severity and repeated bleeding episodes are not completely clearly defined.Objective: To characterize a Portuguese population hospitalized due to colonic diverticular bleeding and to identify the clinical predictors related to bleeding severity and rebleeding.Methods: Retrospective analysis of all hospitalized patients diagnosed with colonic diverticular bleeding from January 2008 to December 2013 at our institution. The main outcomes evaluated were bleeding severity, defined as any transfusion support requirements and/or signs of hemodynamic shock, and 1-year recurrence rate.Results: Seventy-four patients were included, with a mean age of 75.7 ± 9.5 years; the majority were male (62.2%). Thirty-six patients (48.6%) met the criteria for severe bleeding; four independent risk factors for severe diverticular bleeding were identified: low hemoglobin level at admission (≤ 11 g/dL; OR 18.8), older age (≥ 75 years; OR 4.7), bilateral diverticular location (OR 14.2) and chronic kidney disease (OR 5.6). The 1-year recurrence rate was 12.9%. We did not identify any independent risk factor for bleeding recurrence in this population.Conclusion: In this series, nearly half of the patients hospitalized with diverticular bleeding presented with severe bleeding. Patients with low hemoglobin levels, older age, bilateral diverticular location and chronic kidney disease had a significantly increased risk for severe diverticular bleeding. In addition, a small number of patients rebled within the first year after the index episode, although we could not identify independent risk factors associated with the recurrence of diverticular bleeding.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for severity and recurrence of colonic diverticular bleeding

Joaquim¹,

Caldeira²,

Antunes³

et al. 2016

Rev Esp Enferm Dig

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“…3. In this approach, patients with ongoing hematochezia have emergency angiography and, if it is positive, angiographic embolization or surgery is (Jensen andMachicado 1988, 1997;Jensen et al 2000Jensen et al , 2008Athanasoulis 1980;Jensen 2005). performed (Jensen andMachicado 1997, 1998;Jensen 2001, 2005). If there is rebleeding, then the angiogram is repeated or an RBC scan is performed.…”

Section: Traditional Management Of Severe Hematochezia In Adultsmentioning

confidence: 99%

“…6. Prevalence of definitive, presumptive and incidental diverticular hemorrhage in 326 patients with diverticulosis and severe hematochezia (Jensen andMachicado 1988, 1997;Jensen et al 2000Jensen et al , 2008Athanasoulis 1980;Jensen 2005). non-diverticular sources for the rebleeding varied according to treatment, from 43% (medical) or 50% (endoscopic group) to 100% (surgical group). In other words, at least 50% of all the late rebleeding was from non-diverticular sources of LGI hemorrhage in these patients with documented colon diverticulosis (Jensen et al 2008).…”

Section: Diverticular Hemorrhagementioning

confidence: 99%

Diagnostic and Therapeutic Procedures in Gastroenterology

Wu¹,

Sridhar²

2011

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“…The cumulative rate of recurrent severe hematochezia was 21% over a mean of 47 months. 10 On repeat urgent colonoscopy, about half had diverticulosis as the cause and half had another GI diagnosis. It appears that surgery can be obviated in almost all patients after the index diverticular bleed, when colonoscopic techniques are used.…”

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confidence: 99%