alexa Effective Management of Severe Diverticular Bleeding in Japanese Patients | OMICS International| Abstract

Journal of Colitis & Diverticulitis

  • Research Article   
  • J Colitis Diverticulitis 1: 106,

Effective Management of Severe Diverticular Bleeding in Japanese Patients

Yoshihito Nakagawa*, Toshiaki Kamano, Naoki Ohmiya, Tomomitsu Tahara, Tomoyuki Shibata and Ichiro Hirata
Department Of Gastroenterology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
*Corresponding Author : Yoshihito Nakagawa, Department Of Gastroenterology, Fujita Health University, School Of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 4701192, Japan, Tel: +81-562-93-9240, Fax: +81-562-93-8300, Email: [email protected]

Received Date: Mar 03, 2016 / Accepted Date: Mar 08, 2016 / Published Date: Mar 11, 2016

Abstract

Aim: Diverticular bleeding is a common cause of lower gastrointestinal bleeding. Aggressive treatment because of spontaneous hemostasis is typically required only in severe cases. To determine the clinical characteristics of Japanese patients with diverticular bleeding and evaluate the treatment methods used with the aim of developing an effective management approach.

Method: We conducted a retrospective cohort study of 626 Japanese patients (769 endoscopic procedures) who underwent diagnostic lower gastrointestinal endoscopy at Fujita Health University Hospital between November 2011 and April 2014.

Results: Diverticular bleeding was the most frequent cause of lower gastrointestinal bleeding, occurring in 155 patients. Concurrent illness, such as hypertension, was common and 92 patients were receiving anticoagulant or antiplatelet therapy on admission. However, no significant clinical differences were observed between patients with severe and mild diverticular bleeding. Computed tomography (CT) was useful for a treatment policy decision of the one from diverticular bleeding as well as other lower gastrointestinal bleeding. Clipping via colonoscopy could stop bleeding effectively for patients with an identified bleeding point. Barium impaction had utility in patients with persistent bleeding. Angiographic hemostasis or colectomy (intestinal resection) was only performed in uncontrolled patients in whom clipping and barium impaction was not possible.

Conclusion: No significant clinical differences were observed between patients with severe and mild diverticular bleeding. CT angiography was useful for a treatment policy decision of the one from diverticular bleeding. Endoscopic clipping and barium impaction had efficacy in severe cases of diverticular bleeding, at first.

Keywords: Angiographic hemostasis; Colectomy; CT angiography; Diverticular bleeding; Endoscopic clipping; High-dose barium impaction

Citation: Nakagawa Y, Kamano T, Ohmiya N, Tahara T, Shibata T, et al. (2016) Effective Management of Severe Diverticular Bleeding in Japanese Patients. J Colitis Diverticulitis 1: 106.

Copyright: ©2016 Nakagawa Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Review summary

  1. Fay Kaiser
    Posted on Sep 15 2016 at 12:04 pm
    The authors examined lower gastrointestinal bleeding in Japanese patients who underwent gastrointestinal endoscopy. The purpose of their study is to evaluate the disease characteristics of diverticular bleeding and to devise treatment regimen for these patients for better management of the disease. They identified diverticular bleeding is the frequent cause of gastrointestinal bleeding and is associated with hypertension and other illnesses. Based on the data there were no clinical differences between patients with severe and mild diverticular bleeding. The authors systematically performed very good analyses. This study is helpful in planning the right kind of treatment and policy decision
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