Endoscopic therapy of acute diverticular hemorrhage

Bloomfeld, Richard S.; Rockey, Don C.; Shetzline, Michael A.

doi:10.1111/j.1572-0241.2001.04048.x

Cited by 133 publications

(65 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, no early or delayed recurrence (after a median follow-up of 2 years) took place in the patients who underwent endoscopic haemostatic treatment with epinephrine injection and/or bipolar coagulation, a statistically significant difference. However in another study, 38% of the patients experienced recurrent bleeding after endoscopic haemostasis [73]. Endoscopic treatment may modify the natural history of diverticular bleeding by preventing recurrences, but its role has to be further clarified in larger studies with longer follow-up periods.…”

Section: Clinical Picturementioning

confidence: 99%

Colonic Diverticular Disease: Pathophysiology and Clinical Picture

Parra‐Blanco

2006

Digestion

View full text Add to dashboard Cite

Colonic diverticulosis is the most frequent structural abnormality of the large bowel, although it was a rarity before the 20th century. Lifestyle changes in westernized societies with reduced fiber diet are supposed to be the main cause for its high prevalence nowadays. In African countries, where staple diet is rich in fiber, diverticulosis remains very infrequent. Prevalence increases with ageing too. A fiber-deficient diet and subsequent reduction in bowel content volume would lead to increased intraluminal pressures and colonic segmentation, thus promoting diverticula formation. Animal and human studies have shown increased intracolonic pressures in patients with diverticulosis. Alterations in colonic muscle properties, collagen metabolism and in the interactions of the extracellular matrix components may play a role in remodelling the gut wall in diverticular disease. At least one fourth of patients with diverticulosis will develop symptoms, sometimes overlapping with irritable bowel syndrome, but 10–25% will suffer diverticulitis and 3–5% diverticular bleeding. Conservative medical management is usually sufficient in the first episode of diverticulitis, but surgical treatment is generally advocated in recurrences. Diverticular bleeding is a major cause of lower digestive haemorrhage, but generally self-limited. With the application of therapeutic endoscopic and angiographic methods, emergency surgery can often be avoided.

show abstract

Section: Clinical Picturementioning

confidence: 99%

Colonic Diverticular Disease: Pathophysiology and Clinical Picture

Parra‐Blanco

2006

Digestion

View full text Add to dashboard Cite

show abstract

“…However, in their study, only five patients had active bleeding and five patients had a nonbleeding visible vessel. In a retrospective review by Bloomfeld et al of 13 patients presenting with acute lower GIB who underwent endoscopic therapy using IE and/or CTC, five (39%) experienced recurrent bleeding (within 30 days of the index bleed), four of whom required surgical intervention [13]. In a prospective study by Green et al, where patients were randomized to urgent colonoscopy or standard care, ongoing bleeding was suspected in 27 of 50 (54%) patients randomized to urgent colonoscopy.…”

Section: Discussionmentioning

confidence: 96%

Effectiveness of Endoclips for the Treatment of Stigmata of Recent Hemorrhage in the Colon of Patients with Acute Lower Gastrointestinal Tract Bleeding

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Some reports have indicated that Western countries usually performed thermal contact therapy[18,26,28,29]; however, this therapy is not approved in Japan[30]. Several reports from Western countries showed that clipping was a useful hemostasis treatment[12,31,32], and clipping may be performed as a common endoscopic treatment for CDB patients.…”

Section: Discussionmentioning

confidence: 99%

Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire study

Niikura

Nagata

Doyama

et al. 2016

WJGE

View full text Add to dashboard Cite

AIMTo clarify the current state of practice for colonic diverticular bleeding (CDB) in Japan.METHODSWe conducted multicenter questionnaire surveys of the practice for CDB including clinical settings (8 questions), diagnoses (8 questions), treatments (7 questions), and outcomes (4 questions) in 37 hospitals across Japan. The answers were compared between hospitals with high and low number of inpatient beds to investigate which factor influenced the answers.RESULTSEndoscopists at all 37 hospitals answered the questions, and the mean number of endoscopists at these hospitals was 12.7. Of all the hospitals, computed tomography was performed before colonoscopy in 67% of the hospitals. The rate of bowel preparation was 46.0%. Early colonoscopy was performed within 24 h in 43.2% of the hospitals. Of the hospitals, 83.8% performed clipping as first-line endoscopic therapy. More than half of the hospitals experienced less than 20% rebleeding events after endoscopic hemostasis. No significant difference was observed in the annual number of patients hospitalized for CDB between high- (≥ 700 beds) and low-volume hospitals. More emergency visits (P = 0.012) and endoscopists (P = 0.015), and less frequent participation of nursing staff in early colonoscopy (P = 0.045) were observed in the high-volume hospitals.CONCLUSIONSome practices unique to Japan were found, such as performing computed tomography before colonoscopy, no bowel preparation, and clipping as first-line therapy. Although, the number of staff differed, the practices for CDB were common irrespective of hospital size.

show abstract

Endoscopic therapy of acute diverticular hemorrhage

Abstract: Endoscopic therapy can provide early hemostasis in some cases of acute diverticular hemorrhage. However, its value in preventing subsequent diverticular bleeding is unclear.

Cited by 133 publications

References 17 publications

Colonic Diverticular Disease: Pathophysiology and Clinical Picture

Colonic Diverticular Disease: Pathophysiology and Clinical Picture

Effectiveness of Endoclips for the Treatment of Stigmata of Recent Hemorrhage in the Colon of Patients with Acute Lower Gastrointestinal Tract Bleeding

Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire study

Contact Info

Product

Resources

About