Hemostasis of a bleeding inverted colonic diverticulum

Area of Science:

• Gastroenterology
• Endoscopy
• Colorectal Surgery

Background:

• Lower gastrointestinal bleeding is a common emergency presentation.
• Diverticular disease is a frequent cause of lower GI bleeding.
• Inverted diverticula are a rare finding during colonoscopy.

Observation:

• A 62-year-old male presented with hematochezia.
• Colonoscopy revealed sigmoid diverticulosis with two inverted diverticula.
• Oozing hemorrhage from a visible vessel atop the distal inverted diverticulum was noted.

Findings:

• Successful endoscopic hemostasis was achieved using an over-the-scope clip.
• The clip was deployed after suctioning the inverted diverticulum into the transparent cap.
• This technique effectively controlled the active bleeding.

Implications:

• Over-the-scope clips are effective for managing bleeding from inverted colonic diverticula.
• Endoscopic management offers a minimally invasive alternative to surgery for such cases.
• This case highlights the importance of careful endoscopic evaluation in patients with diverticular bleeding.