ENDOSCOPIC BAND LIGATION WITH A WATER-JET SCOPE FOR THE TREATMENT OF COLONIC DIVERTICULAR HEMORRHAGE

Abstract

Although lower gastrointestinal bleeding generally has a less severe course and stops spontaneously in most cases without therapeutic intervention, some patients require endoscopic, surgical, or angiographic treatment depending on the nature of the bleeding. We applied endoscopic band ligation (EBL) with a water-jet scope to bleeding colonic diverticula and evaluated the efficacy and safety of EBL retrospectively. Five consecutive patients were diagnosed as having colonic diverticular hemorrhage, and were treated with EBL at St Luke's International Hospital in Tokyo from June 2009 to August 2009. Comorbid diseases, usage of anti-platelet agents, hemoglobin level on admission, procedural time, complications such as perforation and abscess formation, and rebleeding after EBL were retrospectively evaluated. In all cases, EBL achieved successful immediate hemostasis without any procedural complications. In four of five cases, bleeding colonic diverticula were everted after EBL. The mean length of hospital stay after EBL was 5 days (range 4-8 days). No patient exhibited clinical evidence of further bleeding during the mean follow-up period of 3 months (range 2-4 months), and no further intervention was needed after EBL. EBL with a water-jet scope is considered to be a safe and effective endoscopic treatment for colonic diverticular hemorrhage.