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Colonic diverticular bleeding: An update on pathogenesis and management.

Sneha Annie Sebastian1, Edzel Lorraine Co2, Venkatesh Panthangi3

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Summary

Colonic diverticular bleeding, a common cause of lower GI bleeding, is increasing in older adults. The over-the-scope clip (OTSC) method shows promise for severe cases, especially rebleeding.

Keywords:
Colonic diverticular bleedingDiverticulosisEndoscopic hemostasisOTSC

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Hemorrhage Management

Background:

  • Colonic diverticular bleeding is a prevalent, potentially life-threatening condition, particularly in aging populations.
  • Increased use of anticoagulants/antiplatelets contributes to a higher incidence of acute diverticular bleeding.
  • Severe bleeding often necessitates transfusions or emergency surgery, highlighting the need for effective interventions.

Approach:

  • This review summarizes the pathophysiology of colonic diverticulosis and diverticular bleeding.
  • It examines recent evidence on management strategies and preventive measures.
  • The efficacy and outcomes of the over-the-scope clip (OTSC) technique are discussed.

Key Points:

  • The over-the-scope clip (OTSC) method is an effective endoscopic hemostatic technique for severe diverticular bleeding.
  • OTSC is particularly valuable in managing rebleeding after conventional endoscopic procedures.
  • Understanding pathophysiology and exploring preventive strategies are crucial for controlling diverticular bleeding.

Conclusions:

  • The OTSC method offers a promising solution for challenging cases of colonic diverticular bleeding.
  • Further research into preventive strategies may reduce the incidence and severity of this condition.
  • Effective endoscopic management, including OTSC, is vital for improving patient outcomes.