ENDOSCOPIC TREATMENT STRATEGIES FOR COLONIC DIVERTICULAR BLEEDING BASED ON RECENT REPORTS

Abstract

As there is no specific medication for colonic diverticular bleeding (CDB), high rate of rebleeding is a clinical challenge. The efficacy of endoscopic treatment in reducing rebleeding has been studied, and various methods have been proposed. However, most of the reports up to 2020 were single-center studies with few cases, thus lacking any convincing evidence.

Recently, several reports on CDB from the CODE BLUE-J study, a nationwide study of acute hematochezia cases in Japan, have suggested the followings: i) the strategy of finding and treating bleeding points during colonoscopy, in patients with suspected CDB, helps in reducing recurrent bleeding; ii) endoscopic treatment is more recommendable for right-colon CDB than left-colon CDB; and iii) band ligation is more effective than clipping, with the choice of treatment method depending on the situation, especially in right-colon CDB. These findings can contribute in standardizing the indications and strategies for endoscopic treatment of CDB.