Risk Factor Analysis for Early Rebleeding After Endoscopic Treatment for Colonic Diverticular Bleeding with Stigmata of Recent Hemorrhage

Overview

Journal JGH Open

Specialty Gastroenterology

Date 2021 May 20

PMID 34013057

Citations 2

Authors

Atsushi Yamauchi

Tadayuki Kou

Takuya Kishimoto

Yuki Mori

Kazuki Osawa

Kei Iimori

Kosuke Iwano

Yuya Kawai

Kenji Sawada

Kensuke Hamada

Satoshi Nishimura

Yoshiharu Mori

Kotaro Watanabe

Shunjiro Azuma

Toshihiro Morita

Akira Kurita

Kiyotaka Kawaguchi

Yoshiki Suginoshita

Toshiro Katayama

Shujiro Yazumi

Affiliations

Soon will be listed here.

Abstract

Background And Aim: Colonic diverticular bleeding is a common cause of acute lower gastrointestinal bleeding. Endoscopic hemostasis is generally selected as the first-line treatment; however, a considerable number of patients experience early rebleeding after endoscopic treatment. We investigated the risk factors for early rebleeding after endoscopic treatment.

Methods: We retrospectively evaluated the data of 142 consecutive patients who underwent endoscopic treatment (endoscopic clipping or endoscopic band ligation) for colonic diverticular bleeding with stigmata of recent hemorrhage between April 2012 and April 2020. Multivariate logistic regression analysis was conducted to evaluate the statistical relationship between patient characteristics and the incidence of early rebleeding occurring within 30 days after endoscopic treatment.

Results: Of 142 patients, early rebleeding was detected in 34 (23.9%) patients. According to univariate analysis, platelet count of <10 × 10/μL, bleeding from the left-sided colon, and endoscopic clipping usage were associated with early rebleeding ( < 0.05). The subsequent multivariate logistic regression analysis identified bleeding from the left-sided colon (odds ratio [OR], 4.16; 95% confidence interval [CI], 1.73-10.0; = 0.001) and endoscopic clipping usage (OR, 2.92; 95% CI, 1.21-7.00; = 0.017) as the independent risk factors for early rebleeding.

Conclusions: Bleeding from the left-sided colon and endoscopic clipping usage were the risk factors for early rebleeding after endoscopic treatment. Using endoscopic band ligation was associated with a decreased risk for early rebleeding compared with the use of endoscopic clipping, indicating that endoscopic band ligation was a preferable endoscopic modality to prevent early recurrent bleeding.

Citing Articles

Early rebleeding rate following endoscopic treatment of colonic diverticular bleeding: a systematic review and meta-analysis.

Delaleeuwe I, Aoun J, Reynaert H, Gkolfakis P, Eisendrath P Ann Gastroenterol. 2025; 38(1):41-50.

PMID: 39802288 PMC: 11724377. DOI: 10.20524/aog.2025.0940.

Direct observation of an exposed blood vessel in a colonic diverticulum using ultrathin endoscopy.

Suzuki K, Kikuchi D, Yamashita S DEN Open. 2024; 5(1):e70032.

PMID: 39478703 PMC: 11522026. DOI: 10.1002/deo2.70032.

Is bowel preparation necessary for early colonoscopy in patients with suspected colonic diverticular bleeding?: A multicenter retrospective study with propensity score matching analysis.

Gonai T, Toya Y, Kudara N, Abe K, Sawaguchi S, Fujiwara T DEN Open. 2023; 4(1):e311.

PMID: 37927949 PMC: 10622738. DOI: 10.1002/deo2.311.

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