Related Experiment Video
Updated: Oct 24, 2025
Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
Published on: October 16, 2013
Efficient Colonoscopic Identification of Colonic Bleeding Diverticulum Using Intradiverticular Water Injection with a
Yoshinori Sato1, Satoko Nakatsu-Inaba1, Yasumasa Matsuo1
1Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, Kawasaki, Japan.
Insights
Identifying stigmata of recent hemorrhage (SRH) in colonic diverticular bleeding (CDB) is challenging. Expert colonoscopists using a nontraumatic (NT) tube significantly improve SRH identification during colonoscopy.
Area of Science:
- Gastroenterology
- Endoscopy
- Colorectal Surgery
Background:
- Colonic diverticular bleeding (CDB) poses diagnostic challenges.
- Identifying stigmata of recent hemorrhage (SRH) during colonoscopy for CDB is often difficult.
Purpose of the Study:
- To investigate factors influencing the identification of SRH in patients diagnosed with CDB.
- To determine predictors for SRH detection during colonoscopy for acute lower gastrointestinal bleeding.
Main Methods:
- Retrospective analysis of 487 patients undergoing early colonoscopy for acute lower gastrointestinal bleeding diagnosed as CDB.
- Assessment of comorbidities, medications, bowel preparation, transparent cap, water-jet scope, expert colonoscopist, and nontraumatic (NT) tube use.
- Multivariate analysis to identify independent predictive factors for SRH.
Main Results:
- SRH was definitively identified in 191 (39%) of 487 CDB patients.
- Univariate analysis indicated transparent cap, water-jet scope, expert colonoscopist, and NT tube as predictive factors for SRH.
- Multivariable logistic regression confirmed expert colonoscopist and NT tube use as significant predictors of SRH.
Conclusions:
- Expert colonoscopists utilizing a nontraumatic (NT) tube enhance SRH identification in CDB.
- Intradiverticular water injection with an NT tube by an expert may aid in effective endoscopic hemostasis for CDB.
Objectives:
The colonoscopic identification of stigmata of recent hemorrhage (SRH) in patients with colonic diverticular bleeding (CDB) is difficult. Factors that influence the identification of SRH in the diagnosis of CDB were investigated.
Methods:
This was a retrospective study of 487 early colonoscopy patients with acute lower gastrointestinal bleeding who were diagnosed with CDB. Comorbidities, medications, bowel preparation, use of a transparent cap, use of a water-jet scope, colonoscopy by an expert colonoscopist, and use of a nontraumatic (NT) tube were assessed. A multivariate analysis was used to estimate the odds ratio and 95% confidence interval.
Results:
Of the 487 colonoscopy patients diagnosed with CDB, 191 (39%) were definitively identified with SRH. The use of a transparent cap, a water-jet scope, an expert colonoscopist, and an NT tube were independent predictive factors for SRH on univariate analysis. A multivariable logistic regression model showed that colonoscopy by an expert colonoscopist and the use of an NT tube were predictive factors for SRH.
Conclusions:
Intradiverticular water injection with an NT tube by an expert colonoscopist is useful in identifying CDB, and may help achieve effective endoscopic hemostasis.
Related Concept Videos
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
01:25Endoscopic Procedures II: Colonoscopy
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...