A CASE OF COLONIC DIVERTICULAR BLEEDING IN WHICH HEMOSTASIS WAS UNSUCCESSFUL BY CLIPPING BUT WAS SUCCESSFUL USING HEMOSTATIC FORCEPS

Abstract

The patient was a 90-year-old man who underwent hemostasis by clipping for active diverticular bleeding in the sigmoid colon performed by a previous doctor. After the procedure, the patient had two bleeding episodes that were difficult to manage, and he was transferred to our hospital. During lower digestive tract endoscopy, the responsible diverticulum was visualized, and the attached clip was observed close to the diverticulum. The clip was removed using an end-gripping forceps to clearly visualize the point of bleeding. A small blood vessel was exposed and cauterized by soft coagulation with a slight touch with the tip of the hemostatic forceps (Coagulasper, Olympus, Tokyo), and the diverticular area was clipped with the reefing method to prevent delayed perforation. To the best of our knowledge, no cases of successful endoscopic hemostasis of diverticular bleeding using hemostatic forceps where hemostasis had been unsuccessful by clipping have been reported. Here, we report such a case with a literature review.