Abstract
Colonic diverticular could bleed recurrently, and, sometimes, fatal massive bleeding could occur. However, the choice of endoscopic hemostasis remains controversial. Although the over-the-scope clip (OTSC) method has been reported to be effective, it has not been fully evaluated due to the small number of cases. This study aimed to evaluate the efficacy of the OTSC method for colonic diverticular bleeding. Between August 2017 and December 2020, 36 consecutive patients, including those who could not be treated using endoscopic band ligation (EBL) and those in whom re-bleeding had occurred after EBL, underwent the OTSC method for hemostasis of colonic diverticular bleeding at Hyogo Prefectural Awaji Medical Center. The procedure success rate, adverse events rate, early phase re-bleeding rate (within 30 days following primary hemostasis), and the requirement rate for additional transcatheter arterial embolization (TAE) or surgery were the outcomes assessed. The outcomes were procedure success rate 100%, adverse events rate 0%, early phase re-bleeding rate 8.3%, and additional TAE or surgery rate 0%. These results suggest that the OTSC method is a safe and effective treatment for managing colonic diverticular bleeding.
Highlights
Received: 31 March 2021Accepted: 16 June 2021Published: 29 June 2021Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Licensee MDPI, Basel, Switzerland.This article is an open access articleColonic diverticular bleeding results in spontaneous hemostasis in 66–93% of cases [1,2,3], but could sometimes cause recurrent bleeding or fatal massive bleeding
The over-the-scope clip (OTSC) (Ovesco Endoscopy AG, Tübingen, Germany) is a shape-memorized clip made of nitinol (Figure 1) that is used for suturing tissue or for securing hemostasis during gastrointestinal tract bleeding
Patientsbleeding, and Methods gastrointestinal and out of these, 36 consecutive cases that were diagnosed with colonic diverticular bleeding accompanied by stigmata of recent hemorrhage (SRH) [4]
Summary
Received: 31 March 2021Accepted: 16 June 2021Published: 29 June 2021Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Licensee MDPI, Basel, Switzerland.This article is an open access articleColonic diverticular bleeding results in spontaneous hemostasis in 66–93% of cases [1,2,3], but could sometimes cause recurrent bleeding or fatal massive bleeding. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. This article is an open access article. Colonic diverticular bleeding results in spontaneous hemostasis in 66–93% of cases [1,2,3], but could sometimes cause recurrent bleeding or fatal massive bleeding. When the source of bleeding can be identified, endoscopic hemostasis is the first choice of treatment. No randomized controlled trial has evaluated respective treatments for endoscopic hemostasis in colonic diverticular bleeding, and the most effective endoscopic hemostatic method has not been ascertained. The over-the-scope clip (OTSC) (Ovesco Endoscopy AG, Tübingen, Germany) is a shape-memorized clip made of nitinol (Figure 1) that is used for suturing tissue or for securing hemostasis during gastrointestinal tract bleeding
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