Successful hemostasis after rebleeding of a diverticular hemorrhage achieved with a combination of clipping and an absorbable local hemostatic agent

Abstract

A man in his 70s with lower gastrointestinal bleeding was admitted to the emergency department. The next day, a total colonoscopy (TCS) revealed blood clots in a sigmoid colon diverticulum. When the clots were removed, pulsatile bleeding occurred, and hemostasis was achieved using the clipping method. On day 4, bloody stool was observed, and TCS was performed for hemostasis with an additional clip. On day 6, hematochezia was again observed, and TCS revealed bleeding from the same site. Another clip was added and 3 mL of an absorbable local hemostatic agent (PuraStat^®; 3-D Matrix) was applied. No further bleeding was observed. Our technique may be useful to treat cases of diverticular hemorrhage with a high risk of rebleeding.