Table of Contents Author Guidelines Submit a Manuscript
Gastroenterology Research and Practice
Volume 2014 (2014), Article ID 353508, 5 pages
http://dx.doi.org/10.1155/2014/353508
Review Article

Endoscopic Management of Diverticular Bleeding

1Section of Digestive Diseases, Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, 1080 LMP, New Haven, CT 06520, USA
2Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA

Received 19 October 2014; Accepted 23 November 2014; Published 9 December 2014

Academic Editor: Rami Eliakim

Copyright © 2014 Tarun Rustagi and Thomas R. McCarty. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. L. Laine, H. Yang, S.-C. Chang, and C. Datto, “Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009,” The American Journal of Gastroenterology, vol. 107, no. 8, pp. 1190–1195, 2012. View at Publisher · View at Google Scholar · View at Scopus
  2. K. A. Ghassemi and D. M. Jensen, “Lower GI bleeding: epidemiology and management topical collection on large intestine,” Current Gastroenterology Reports, vol. 15, no. 7, article 333, 2013. View at Publisher · View at Google Scholar · View at Scopus
  3. C. J. Gostout, K. K. Wang, and D. A. Ahlquist, “Acute gastrointestinal bleeding. Experience of a specialized management team,” Journal of Clinical Gastroenterology, vol. 14, no. 3, pp. 260–267, 1992. View at Publisher · View at Google Scholar
  4. C. Gayer, A. Chino, C. Lucas et al., “Acute lower gastrointestinal bleeding in 1,112 patients admitted to an urban emergency medical center,” Surgery, vol. 146, no. 4, pp. 600–607, 2009. View at Publisher · View at Google Scholar · View at Scopus
  5. W. Browder, E. J. Cerise, and M. S. Litwin, “Impact of emergency angiography in massive lower gastrointestinal bleeding,” Annals of Surgery, vol. 204, no. 5, pp. 530–536, 1986. View at Publisher · View at Google Scholar · View at Scopus
  6. U. Navaneethan, B. Njei, P. G. K. Venkatesh, and M. R. Sanaka, “Timing of colonoscopy and outcomes in patients with lower GI bleeding: a nationwide population-based study,” Gastrointestinal Endoscopy, vol. 79, no. 2, pp. 297.e12–306.e12, 2014. View at Publisher · View at Google Scholar · View at Scopus
  7. G. F. Longstreth, “Epidemiology and outcome of patients hospitalized with acute lower gastrointestinal hemorrhage: a population-based study,” The American Journal of Gastroenterology, vol. 92, no. 3, pp. 419–424, 1997. View at Google Scholar · View at Scopus
  8. V. Chaudhry, M. J. Hyser, V. H. Gracias, and F. C. Gau, “Colonoscopy: the initial test for acute lower gastrointestinal bleeding,” The American Surgeon, vol. 64, no. 8, pp. 723–728, 1998. View at Google Scholar · View at Scopus
  9. L. L. Strate, J. Z. Ayanian, G. Kotler, and S. Syngal, “Risk factors for mortality in lower intestinal bleeding,” Clinical Gastroenterology and Hepatology, vol. 6, no. 9, pp. 1004–1010, 2008. View at Publisher · View at Google Scholar · View at Scopus
  10. A. F. Peery, E. S. Dellon, J. Lund et al., “Burden of gastrointestinal disease in the United States: 2012 update,” Gastroenterology, vol. 143, no. 5, pp. 1179.e3–1187.e3, 2012. View at Publisher · View at Google Scholar · View at Scopus
  11. M. A. Meyers, D. R. Alonso, G. F. Gray, and J. W. Baer, “Pathogenesis of bleeding colonic diverticulosis,” Gastroenterology, vol. 71, no. 4, pp. 577–583, 1976. View at Google Scholar · View at Scopus
  12. D. M. Jensen, “The ins and outs of diverticular bleeding,” Gastrointestinal Endoscopy, vol. 75, no. 2, pp. 388–391, 2012. View at Publisher · View at Google Scholar · View at Scopus
  13. D. M. Jensen and G. A. Machicado, “Diagnosis and treatment of severe hematochezia. The role of urgent colonoscopy after purge,” Gastroenterology, vol. 95, no. 6, pp. 1569–1574, 1988. View at Google Scholar · View at Scopus
  14. W. J. Casarella, I. E. Kanter, and W. B. Seaman, “Right-sided colonic diverticula as a cause of acute rectal hemorrhage,” The New England Journal of Medicine, vol. 286, no. 9, pp. 450–453, 1972. View at Publisher · View at Google Scholar · View at Scopus
  15. R. V. Rege and D. L. Nahrwold, “Diverticular disease,” Current Problems in Surgery, vol. 26, no. 3, pp. 139–189, 1989. View at Publisher · View at Google Scholar · View at Scopus
  16. S.-K. Wong, Y.-H. Ho, A. P. K. Leong, and F. Seow-Choen, “Clinical behavior of complicated right-sided and left-sided diverticulosis,” Diseases of the Colon and Rectum, vol. 40, no. 3, pp. 344–348, 1997. View at Publisher · View at Google Scholar · View at Scopus
  17. H. H. McGuire Jr., “Bleeding colonic diverticula: a reappraisal of natural history and management,” Annals of Surgery, vol. 220, no. 5, pp. 653–656, 1994. View at Publisher · View at Google Scholar · View at Scopus
  18. A. Yamada, T. Sugimoto, S. Kondo et al., “Assessment of the risk factors for colonic diverticular hemorrhage,” Diseases of the Colon & Rectum, vol. 51, no. 1, pp. 116–120, 2008. View at Publisher · View at Google Scholar · View at Scopus
  19. N. Tsuruoka, R. Iwakiri, M. Hara et al., “NSAIDs are a significant risk factor for colonic diverticular hemorrhage in elder patients: evaluation by a case-control study,” Journal of Gastroenterology and Hepatology, vol. 26, no. 6, pp. 1047–1052, 2011. View at Publisher · View at Google Scholar · View at Scopus
  20. L. L. Strate, Y. L. Liu, W. H. Aldoori, S. Syngal, and E. L. Giovannucci, “Obesity increases the risks of diverticulitis and diverticular bleeding,” Gastroenterology, vol. 136, no. 1, pp. 115.e1–122.e1, 2009. View at Publisher · View at Google Scholar · View at Scopus
  21. R. Niikura, N. Nagata, A. Yamada, J. Akiyama, T. Shimbo, and N. Uemura, “Recurrence of colonic diverticular bleeding and associated risk factors,” Colorectal Disease, vol. 14, no. 3, pp. 302–305, 2012. View at Publisher · View at Google Scholar · View at Scopus
  22. N. Nagata, R. Niikura, T. Aoki et al., “Colonic diverticular hemorrhage associated with the use of nonsteroidal anti-inflammatory drugs, low-dose aspirin, antiplatelet drugs, and dual therapy,” Journal of Gastroenterology and Hepatology, vol. 29, no. 10, pp. 1786–1793, 2014. View at Publisher · View at Google Scholar
  23. S. Suh, P. J. Seo, H. Park et al., “The risk factors for colonic diverticular bleeding,” The Korean Journal of Gastroenterology, vol. 60, no. 6, pp. 349–354, 2012. View at Publisher · View at Google Scholar · View at Scopus
  24. Y. Fujino, Y. Inoue, M. Onodera et al., “Risk factors for early re-bleeding and associated hospitalization in patients with colonic diverticular bleeding,” Colorectal Disease, vol. 15, no. 8, pp. 982–986, 2013. View at Publisher · View at Google Scholar · View at Scopus
  25. R. Niikura, N. Nagata, T. Aoki et al., “Predictors for identification of stigmata of recent hemorrhage on colonic diverticula in lower gastrointestinal bleeding,” Journal of Clinical Gastroenterology, 2014. View at Publisher · View at Google Scholar · View at Scopus
  26. D. M. Jensen, G. A. Machicado, R. Jutabha, and T. O. G. Kovacs, “Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage,” The New England Journal of Medicine, vol. 342, no. 2, pp. 78–82, 2000. View at Publisher · View at Google Scholar · View at Scopus
  27. A. Mizuki, M. Tatemichi, K. Hatogai et al., “Timely colonoscopy leads to faster identification of bleeding diverticulum,” Japanese Journal of Gastroenterology, vol. 110, no. 11, pp. 1927–1933, 2013. View at Google Scholar · View at Scopus
  28. N. Schmulewitz, D. A. Fisher, and D. C. Rockey, “Early colonoscopy for acute lower GI bleeding predicts shorter hospital stay: a retrospective study of experience in a single center,” Gastrointestinal Endoscopy, vol. 58, no. 6, pp. 841–846, 2003. View at Publisher · View at Google Scholar · View at Scopus
  29. D. Y. Lhewa and L. L. Strate, “Pros and cons of colonoscopy in management of acute lower gastrointestinal bleeding,” World Journal of Gastroenterology, vol. 18, no. 11, pp. 1185–1190, 2012. View at Publisher · View at Google Scholar · View at Scopus
  30. L. L. Strate and C. R. Naumann, “The role of colonoscopy and radiological procedures in the management of acute lower intestinal bleeding,” Clinical Gastroenterology and Hepatology, vol. 8, no. 4, pp. 333–343, 2010. View at Publisher · View at Google Scholar · View at Scopus
  31. B. T. Green, D. C. Rockey, G. Portwood et al., “Urgent colonoscopy for evaluation and management of acute lower gastrointestinal hemorrhage: a randomized controlled trial,” The American Journal of Gastroenterology, vol. 100, no. 11, pp. 2395–2402, 2005. View at Publisher · View at Google Scholar · View at Scopus
  32. L. Laine and A. Shah, “Randomized trial of urgent vs. elective colonoscopy in patients hospitalized with lower GI bleeding,” The American Journal of Gastroenterology, vol. 105, no. 12, pp. 2636–2641, 2010. View at Publisher · View at Google Scholar · View at Scopus
  33. L. L. Strate, “Lower GI bleeding: epidemiology and diagnosis,” Gastroenterology Clinics of North America, vol. 34, no. 4, pp. 643–664, 2005. View at Publisher · View at Google Scholar · View at Scopus
  34. N. Ishii, T. Setoyama, G. A. Deshpande et al., “Endoscopic band ligation for colonic diverticular hemorrhage,” Gastrointestinal Endoscopy, vol. 75, no. 2, pp. 382–387, 2012. View at Publisher · View at Google Scholar · View at Scopus
  35. R. S. Bloomfeld, D. C. Rockey, and M. A. Shetzline, “Endoscopic therapy of acute diverticular hemorrhage,” The American Journal of Gastroenterology, vol. 96, no. 8, pp. 2367–2372, 2001. View at Publisher · View at Google Scholar · View at Scopus
  36. J. L. Mauldin, “Therapeutic use of colonoscopy in active diverticular bleeding,” Gastrointestinal Endoscopy, vol. 31, no. 4, pp. 290–291, 1985. View at Google Scholar · View at Scopus
  37. J. S. Johnston, “Endoscopic heater probe coagulation of the bleeding colonic diverticulum,” Gastrointestinal Endoscopy, vol. 32, p. A160, 1986. View at Google Scholar
  38. T. J. Savides and D. M. Jensen, “Colonoscopic hemostasis for recurrent diverticular hemorrhage associated with a visible vessel: a report of three cases,” Gastrointestinal Endoscopy, vol. 40, no. 1, pp. 70–73, 1994. View at Publisher · View at Google Scholar · View at Scopus
  39. A. Hokama, T. Uehara, T. Nakayoshi et al., “Utility of endoscopic hemoclipping for colonic diverticular bleeding,” The American Journal of Gastroenterology, vol. 92, no. 3, pp. 543–546, 1997. View at Google Scholar · View at Scopus
  40. E. F. Yen, U. Ladabaum, V. R. Muthusamy, J. P. Cello, K. R. McQuaid, and J. N. Shah, “Colonoscopic treatment of acute diverticular hemorrhage using endoclips,” Digestive Diseases and Sciences, vol. 53, no. 9, pp. 2480–2485, 2008. View at Publisher · View at Google Scholar · View at Scopus
  41. P. W. Simpson, M. H. Nguyen, J. K. Lim, and R. M. Soetikno, “Use of endoclips in the treatment of massive colonic diverticular bleeding,” Gastrointestinal Endoscopy, vol. 59, no. 3, pp. 433–437, 2004. View at Publisher · View at Google Scholar · View at Scopus
  42. Y. Kominami, H. Ohe, S. Kobayashi et al., “Classification of the bleeding pattern in colonic diverticulum is useful to predict the risk of bleeding or re-bleeding after endoscopic treatment,” Journal of Japanese Society of Gastroenterology, vol. 109, no. 3, pp. 393–399, 2012. View at Google Scholar · View at Scopus
  43. N. Ishii, N. Hirata, F. Omata et al., “Location in the ascending colon is a predictor of refractory colonic diverticular hemorrhage after endoscopic clipping,” Gastrointestinal Endoscopy, vol. 76, no. 6, pp. 1175–1181, 2012. View at Publisher · View at Google Scholar · View at Scopus
  44. T. Kaltenbach, R. Watson, J. Shah et al., “Colonoscopy with clipping is useful in the diagnosis and treatment of diverticular bleeding,” Clinical Gastroenterology and Hepatology, vol. 10, no. 2, pp. 131–137, 2012. View at Publisher · View at Google Scholar · View at Scopus
  45. T. Setoyama, N. Ishii, and Y. Fujita, “Enodoscopic band ligation (EBL) is superior to endoscopic clipping for the treatment of colonic diverticular hemorrhage,” Surgical Endoscopy, vol. 25, no. 11, pp. 3574–3578, 2011. View at Publisher · View at Google Scholar · View at Scopus
  46. N. Ishii, T. Itoh, M. Uemura et al., “Endoscopic band ligation with a water-jet scope for the treatment of colonic diverticular hemorrhage,” Digestive Endoscopy, vol. 22, no. 3, pp. 232–235, 2010. View at Publisher · View at Google Scholar · View at Scopus
  47. J. J. Farrell, F. Graeme-Cook, and P. B. Kelsey, “Treatment of bleeding colonic diverticula by endoscopic band ligation: an in-vivo and ex-vivo pilot study,” Endoscopy, vol. 35, no. 10, pp. 823–829, 2003. View at Publisher · View at Google Scholar · View at Scopus
  48. N. Ishii, T. Itoh, Y. Iizuka et al., “Endoscopic band ligation for colonic diverticular rebleeding after endoscopic clipping,” Digestive Endoscopy, vol. 23, no. 2, article 211, 2011. View at Publisher · View at Google Scholar · View at Scopus