ENDOSCOPIC DIAGNOSIS AND TREATMENT FOR COLONIC DIVERTICULAR BLEEDING

Abstract

The increasing frequency of colonic diverticular bleeding along with the increasing frequency of diverticulosis in the background of the rapidly-aging population and more comorbidities has become clinically significant. We often encounter difficulties in identifying the bleeding site in patients with colonic diverticular bleeding due to its feature of intermittent bleeding. Spontaneous cessation of hemorrhage is often experienced; however, rebleeding occurs at a high rate unless proper intervention is provided. Endoscopic clipping and ligation are useful because of their high hemostatic success rates. It is essential to identify SRH （stigmata of recent hemorrhage） during endoscopic examination. There is a high probability of identifying the responsible diverticulum if colonoscopy/contrast-enhanced computed tomography (CT) is performed at the onset of bleeding and a new technique, the “step clipping” method, is used.