Document Detail


Endoscopic hemostasis in acute diverticular bleeding.
MedLine Citation:
PMID:  10494686     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: Early reports of urgent colonoscopy in acute lower intestinal bleeding suggest a role for endoscopic therapy for bleeding colonic lesions, but scant data exist on bleeding diverticula. We report our experience with endoscopic hemostasis in acute diverticular bleeding. PATIENTS AND METHODS: Bleeding diverticula were identified on urgent diagnostic endoscopy in five patients with acute gastrointestinal bleeding, two in the duodenum, and three in the colon. All patients had co-morbid conditions preventing more conventional therapeutic approaches. The five cases are described, including the technique of endoscopic hemostasis and outcome. RESULTS: Endoscopic therapy using epinephrine injection, thermal cautery and/or laser therapy successfully induced hemostasis in all patients. One patient died of co-morbid illness during the hospital stay, while the remaining four patients had no recurrent bleeding over a mean follow-up period of 20.6 months. CONCLUSION: Endoscopic therapy of bleeding diverticula is technically possible when the culprit diverticulum can be identified. This therapeutic modality may have a place in debilitated patients in whom other more invasive procedures are contraindicated, but further experience is needed to establish its safety.
Authors:
C Prakash; H Chokshi; D T Walden; G Aliperti
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Endoscopy     Volume:  31     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-10-19     Completed Date:  1999-10-19     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  460-3     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. prakashc@medicine.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Aged, 80 and over
Diverticulum, Colon / complications*,  diagnosis
Endoscopy, Digestive System
Female
Gastrointestinal Hemorrhage / diagnosis,  etiology,  therapy*
Hemostasis, Endoscopic / methods*
Humans
Length of Stay
Male
Middle Aged
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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