Limits...
Risk factors for early rebleeding after endoscopic band ligation for colonic diverticular hemorrhage.

Ikeya T, Ishii N, Nakano K, Omata F, Shimamura Y, Ego M, Takagi K, Nakamura K, Fukuda K, Fujita Y - Endosc Int Open (2015)

Bottom Line: Early rebleeding could be managed conservatively and/or endoscopically, except in one case in which surgery was done.Multivariate analysis revealed that age under 50 (adjusted OR, 8.7; 95 % CI 1.6 - 52.5; P = 0.014) and AB (adjusted OR, 4.21; 95 % CI 1.15 - 18.1; P = 0.03) were shown to be significant risk factors.The right side of the colon carried less risk than did the left side (adjusted OR, 0.21; 95 % CI 0.04 - 0.84; P = 0.028).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.

ABSTRACT

Background and study aims: Endoscopic band ligation (EBL) has been used for hemostasis of colonic diverticular hemorrhage. However, early rebleeding (< 30 days after EBL) has been reported in some cases. The aim of this study was to elucidate risk factors for early rebleeding after EBL in treatment of colonic diverticular hemorrhage.

Patients and methods: A total of 101 patients with definite diverticular hemorrhage treated using EBL from June 2009 to October 2014 were included in the retrospective cohort study and divided into rebleeding and non-rebleeding groups, depending on the presence or absence of early rebleeding. Patients' ages, comorbid diseases, stigmata of recent hemorrhage (SRH) [active bleeding (AB), non-bleeding visible vessel (NBVV), or adherent clot (AC)], locations of bleeding diverticula, and eversions of the diverticula after EBL were retrospectively evaluated in each group.

Results: Early rebleeding occurred in 15 cases. The median time (range) of early rebleeding occurrence was 5 days (range, 2 h to 26 days). Early rebleeding could be managed conservatively and/or endoscopically, except in one case in which surgery was done. Multivariate analysis revealed that age under 50 (adjusted OR, 8.7; 95 % CI 1.6 - 52.5; P = 0.014) and AB (adjusted OR, 4.21; 95 % CI 1.15 - 18.1; P = 0.03) were shown to be significant risk factors. The right side of the colon carried less risk than did the left side (adjusted OR, 0.21; 95 % CI 0.04 - 0.84; P = 0.028).

Conclusions: Younger age, AB of SRH, and leftsided lesions were identified as the risk factors for early rebleeding after EBL in the treatment of colonic diverticular hemorrhage.

No MeSH data available.


Related in: MedlinePlus

 The banded diverticulum became yellowish on repeat colonoscopy (case 11).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4612237&req=5

FI209-4:  The banded diverticulum became yellowish on repeat colonoscopy (case 11).

Mentions: The banded diverticula transformed into yellowish or black balls on repeat colonoscopy performed in five early rebleeding cases (cases 7 – 11) (Fig. 4), which had no other demonstrable bleeding sources. Eversion of the diverticula after EBL had been observed during the first EBL in five cases. In one of these five cases (case 7), right hemicolectomy was performed as the patient’s preference, whereas the other four cases were managed conservatively without any interventions.


Risk factors for early rebleeding after endoscopic band ligation for colonic diverticular hemorrhage.

Ikeya T, Ishii N, Nakano K, Omata F, Shimamura Y, Ego M, Takagi K, Nakamura K, Fukuda K, Fujita Y - Endosc Int Open (2015)

 The banded diverticulum became yellowish on repeat colonoscopy (case 11).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4612237&req=5

FI209-4:  The banded diverticulum became yellowish on repeat colonoscopy (case 11).
Mentions: The banded diverticula transformed into yellowish or black balls on repeat colonoscopy performed in five early rebleeding cases (cases 7 – 11) (Fig. 4), which had no other demonstrable bleeding sources. Eversion of the diverticula after EBL had been observed during the first EBL in five cases. In one of these five cases (case 7), right hemicolectomy was performed as the patient’s preference, whereas the other four cases were managed conservatively without any interventions.

Bottom Line: Early rebleeding could be managed conservatively and/or endoscopically, except in one case in which surgery was done.Multivariate analysis revealed that age under 50 (adjusted OR, 8.7; 95 % CI 1.6 - 52.5; P = 0.014) and AB (adjusted OR, 4.21; 95 % CI 1.15 - 18.1; P = 0.03) were shown to be significant risk factors.The right side of the colon carried less risk than did the left side (adjusted OR, 0.21; 95 % CI 0.04 - 0.84; P = 0.028).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.

ABSTRACT

Background and study aims: Endoscopic band ligation (EBL) has been used for hemostasis of colonic diverticular hemorrhage. However, early rebleeding (< 30 days after EBL) has been reported in some cases. The aim of this study was to elucidate risk factors for early rebleeding after EBL in treatment of colonic diverticular hemorrhage.

Patients and methods: A total of 101 patients with definite diverticular hemorrhage treated using EBL from June 2009 to October 2014 were included in the retrospective cohort study and divided into rebleeding and non-rebleeding groups, depending on the presence or absence of early rebleeding. Patients' ages, comorbid diseases, stigmata of recent hemorrhage (SRH) [active bleeding (AB), non-bleeding visible vessel (NBVV), or adherent clot (AC)], locations of bleeding diverticula, and eversions of the diverticula after EBL were retrospectively evaluated in each group.

Results: Early rebleeding occurred in 15 cases. The median time (range) of early rebleeding occurrence was 5 days (range, 2 h to 26 days). Early rebleeding could be managed conservatively and/or endoscopically, except in one case in which surgery was done. Multivariate analysis revealed that age under 50 (adjusted OR, 8.7; 95 % CI 1.6 - 52.5; P = 0.014) and AB (adjusted OR, 4.21; 95 % CI 1.15 - 18.1; P = 0.03) were shown to be significant risk factors. The right side of the colon carried less risk than did the left side (adjusted OR, 0.21; 95 % CI 0.04 - 0.84; P = 0.028).

Conclusions: Younger age, AB of SRH, and leftsided lesions were identified as the risk factors for early rebleeding after EBL in the treatment of colonic diverticular hemorrhage.

No MeSH data available.


Related in: MedlinePlus