Recurrent bleeding of colonic diverticular hemorrhage after endoscopic treatment: Clinical experience of an endoscopic center

AimsDiverticular bleeding is one of the most common etiologies of lower GI bleeding. Endoscopy is a useful tool in both diagnosis and therapeutic management. The endoscopic hemostatic methods included epinephrine injection, thermal coagulation, clipping or combination of them. The aim of this study was to evaluate the outcome of different type of hemostasis. Patients and methodsWe reviewed the medical record of all patients who underwent endoscopic therapy for diverticular bleeding from December 2000 to December 2011. We measured hemoglobulin before procedure, early rebleeding (< 30 days), late rebleeding (> 30 days), blood transfusion requirement, hospital stay and complication. ResultsIn our hospital, acute lower GI bleeding leads to almost 600 patients in the past 10 years. We identified 21 patients who underwent endoscopic hemostatic treatment for the diverticular hemorrhage. Patients with epinephrine injection alone had one of thirteen with early rebleeding (< 30 days) and one of thirteen with late rebleeding (> 30 days). Patients with combination therapy (epinephrine injection combined with coagulation or clipping) had one of eight with early bleeding and two of eight patients had late bleeding. There was no significant difference between these two groups on early rebleeding and late rebleeding. ConclusionsIn our series, epinephrine injection alone for diverticular hemorrhage seems to be non-inferior to the combination therapy for providing good initial hemostasis and preventing recurrent bleeding. Copyright (c) 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.