Endoscopic therapy of acute diverticular hemorrhage

OBJECTIVE: Diverticular hemorrhage is a common cause of lower GI bleeding a nd can be diagnosed acutely during colonoscopy. However, whether early diag nosis leads to effective intervention remains controversial. The aim of thi s study was to evaluate whether urgent colonoscopic therapy is effective as acute and long term treatment for diverticular bleeding with stigmata of h emorrhage. METHODS: We reviewed the medical records of all patients who underwent endo scopic therapy for diverticular bleeding from January, 1994 to June, 2000 a t Duke University Medical Center. Patients or their families were contacted to obtain complete follow-up including data on subsequent bleeding. RESULTS: We identified 13 patients who underwent colonoscopic hemostatic ma nagement for the treatment of acute diverticular bleeding. Therapy consiste d of epinephrine injection and/or multipolar electrocoagulation. Five patie nts (38%) experienced early rebleeding, within 30 days of the index bleed, four of whom required surgery, and three patients (23%) had late rebleeding . There were no complications of endoscopic therapy. CONCLUSIONS: Endoscopic therapy can provide early hemostasis in some cases of acute diverticular hemorrhage. However, its value in preventing subseque nt diverticular bleeding is unclear. (C) 2001 by Am. Coll. of Gastroenterol ogy.