Colonic diverticular hemorrhage: the hood method for detecting responsible diverticula and endoscopic band ligation for hemostasis
Colonic diverticular hemorrhage: the hood method for detecting responsible diverticula and endoscopic band ligation for hemostasis
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DOI：
10.1055/s-0033-1344890
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发表时间：
2014-01-01
期刊：
影响因子：
9.3
通讯作者：
Yoshizawa, Kaname
中科院分区：
文献类型：
--
作者：
Shibata, Soichiro;Shigeno, Takashi;Yoshizawa, Kaname
研究背景和研究目的：尽管结肠盲囊出血是下消化道出血的常见原因，但导致出血的盲囊检测率低，加上内窥镜止血评估不足，仍然不令人满意。患者和方法：三年多来，我们对53例憩室出血患者采用罩法诊断，并应用内镜下套扎术（EBL）结果：头罩法显示活动性出血13例（24.5%），无出血血管14例（26.4%），可疑憩室出血26例（49.1%）。13例患者的非出血可见血管位于憩室圆顶，1例患者位于憩室口。27例患者进行了EBL，止血率为96.3%。在9的12例EBL治疗，后续结肠镜检查显示决议的负责憩室。结论：罩的方法提高了憩室负责出血的检测率，揭示潜在的非出血可见血管在憩室圆顶。EBL可能成为治疗结肠憩室出血的有效方法。
Background and study aims: Although colonic diverticular hemorrhage is a common cause of lower gastrointestinal bleeding, the low rate of detection of the diverticula responsible for bleeding, together with inadequate evaluation of endoscopic hemostasis, remain unsatisfactory.Patients and methods: Over 3 years, we employed the hood method to diagnose diverticular hemorrhage in 53 patients and applied endoscopic band ligation (EBL) for hemostasis in 27 patients with responsible diverticula.Results: The hood method revealed active bleeding in 13 patients (24.5%), nonbleeding visible vessels in 14 patients (26.4%), and presumptive diverticular hemorrhage in 26 patients (49.1%). The nonbleeding visible vessels were located in the diverticular dome in 13 patients and at the diverticular orifice in one patient. EBL was performed in 27 patients, and a hemostasis rate of 96.3% was achieved. In 9 of 12 patients treated with EBL, follow-up colonoscopy revealed resolution of the responsible diverticula.Conclusions: The hood method improves the detection rate of diverticula responsible for bleeding by revealing potential nonbleeding visible vessels in the diverticular dome. EBL may become an effective procedure for hemostasis of colonic diverticular hemorrhage.