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Colonic diverticular hemorrhage: the hood method for detecting responsible diverticula and endoscopic band ligation

Soichiro Shibata1, Takashi Shigeno1, Kazuya Fujimori1

  • 1Department of Gastroenterology, Shinshu Ueda Medical Center, Ueda, Nagano, Japan.

Endoscopy
|November 13, 2013
PubMed

Insights

The hood method enhances detection of colonic diverticular hemorrhage. Endoscopic band ligation (EBL) effectively stops bleeding from responsible diverticula, offering a promising treatment for this common gastrointestinal issue.

Area of Science:

  • Gastroenterology
  • Endoscopic procedures
  • Gastrointestinal bleeding

Background:

  • Colonic diverticular hemorrhage is a frequent cause of lower gastrointestinal bleeding.
  • Current diagnostic methods have limitations in identifying bleeding diverticula.
  • Evaluation of endoscopic hemostasis for this condition requires improvement.

Purpose of the Study:

  • To assess the efficacy of the hood method in diagnosing colonic diverticular hemorrhage.
  • To evaluate the effectiveness of endoscopic band ligation (EBL) in achieving hemostasis for bleeding diverticula.

Main Methods:

  • The hood method was utilized for diagnosis in 53 patients over 3 years.
  • Endoscopic band ligation (EBL) was applied for hemostasis in 27 patients with identified bleeding diverticula.

Main Results:

  • The hood method identified active bleeding in 24.5%, nonbleeding visible vessels in 26.4%, and presumptive hemorrhage in 49.1%.
  • Nonbleeding visible vessels were predominantly found in the diverticular dome.
  • EBL achieved a high hemostasis rate of 96.3%, with resolution of diverticula noted in follow-up colonoscopies.

Conclusions:

  • The hood method improves the detection of bleeding diverticula, particularly by identifying nonbleeding visible vessels.
  • Endoscopic band ligation (EBL) presents a potentially effective treatment for colonic diverticular hemorrhage.
Abstract

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