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Gastroenterology Research and Practice
Volume 2015 (2015), Article ID 564536, 4 pages
http://dx.doi.org/10.1155/2015/564536
Research Article

Enteroscopic Diagnosis and Management of Small Bowel Diverticular Hemorrhage: A Multicenter Report from the Taiwan Association for the Study of Small Intestinal Diseases

1Division of Gastroenterology, Department of Internal Medicine, China Medical University Hospital, Taichung 40447, Taiwan
2Endoscopy Center, Department of Gastroenterology, Changhua Christian Hospital, Changhua 50000, Taiwan
3Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 33344, Taiwan
4Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
5Department of Gastroenterology, Buddhist Taichung Tzu Chi Hospital, Taichung 42700, Taiwan
6Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan
7Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan
8Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80700, Taiwan
9Division of Gastroenterology, Tri-Service General Hospital, Taipei 11400, Taiwan

Received 26 May 2015; Accepted 2 July 2015

Academic Editor: Philipp Lenz

Copyright © 2015 Yang-Yuan Chen et al. 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.

Abstract

Small bowel diverticulum is a rare cause of gastrointestinal bleeding. The diagnosis and treatment of small bowel diverticular hemorrhage is clinically challenging before the development of deep enteroscopy. In this multicenter study from the Taiwan Association for the Study of Small Intestinal Diseases (TASSID), 608 patients underwent deep enteroscopy for obscure gastrointestinal bleeding during January 2004 and April 2010 from eight medical centers in Taiwan. Small bowel diverticular hemorrhage account for 7.89% of obscure gastrointestinal bleeding in this study. Most of the patients received endoscopic therapy with an initial hemostasis rate of 85.71% and rebleeding rate of 20%. In this large case series investigating the enteroscopic management of small intestinal diverticular hemorrhage, we found that, as to patients with peptic ulcer hemorrhage, most of these patients can be successfully managed by endoscopic therapy before surgery in the era of deep enteroscopy.