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Endoscopic hemostasis in acute diverticular bleeding.

C Prakash1, H Chokshi, D T Walden

  • 1Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. prakashc@medicine.wustl.edu

Endoscopy
|September 24, 1999
PubMed
Summary
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Endoscopic therapy effectively stopped acute diverticular bleeding in five patients, including those with duodenal and colonic lesions. This approach offers a safe option for debilitated patients when other treatments are not feasible.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Gastrointestinal Bleeding

Background:

  • Limited data exists on endoscopic therapy for bleeding colonic diverticula.
  • Urgent colonoscopy shows potential for treating bleeding colonic lesions.

Purpose of the Study:

  • To report the experience with endoscopic hemostasis in acute diverticular bleeding.
  • To evaluate the efficacy and safety of endoscopic interventions for bleeding diverticula.

Main Methods:

  • Urgent diagnostic endoscopy identified bleeding diverticula in five patients with acute gastrointestinal bleeding.
  • Endoscopic hemostasis techniques included epinephrine injection, thermal cautery, and laser therapy.
  • Patients had co-morbid conditions precluding conventional treatments.

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Main Results:

  • Successful hemostasis was achieved in all five patients using endoscopic therapy.
  • Four out of five patients experienced no recurrent bleeding during a mean follow-up of 20.6 months.
  • One patient died due to co-morbid illness, not related to the procedure.

Conclusions:

  • Endoscopic therapy is technically feasible for identified bleeding diverticula.
  • This modality may be a valuable option for debilitated patients unsuitable for invasive procedures.
  • Further research is needed to fully establish the safety profile of endoscopic hemostasis for diverticular bleeding.