Endoscopic Coagulation with Clipping for Colonic Diverticular Bleeding: A Practical Hemostatic Strategy

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Clinical Outcomes Research

Background:

• Colonic diverticular bleeding presents significant management challenges.
• Endoscopic coagulation with clipping (ECC) is an established technique, but real-world data on its efficacy are limited.

Purpose of the Study:

• To evaluate the clinical outcomes and safety of endoscopic coagulation with clipping (ECC) for colonic diverticular bleeding.
• To determine the rebleeding rates and adverse events associated with ECC.

Main Methods:

• A single-center retrospective case series included 83 patients with endoscopically confirmed colonic diverticular bleeding treated with ECC.
• Data collected from January 2017 to December 2025.
• Rebleeding was defined as recurrent hematochezia within 30 days; adverse events were recorded.

Main Results:

• The overall 30-day rebleeding rate was 8.4% (7/83 patients), with most occurring within 7 days.
• Rebleeding rates varied based on bleeding stigmata: 5.6% for active bleeding and 14.8% for nonbleeding visible vessels/clots.
• Procedure-related adverse events occurred in 3.6% (3/83) of patients and were managed conservatively.

Conclusions:

• Endoscopic coagulation with clipping (ECC) demonstrated a low rebleeding rate in this cohort of patients with colonic diverticular bleeding.
• ECC appears to be a practical and safe hemostatic option when the bleeding diverticulum is clearly identified during endoscopy.