Yen Eugene F, Ladabaum Uri, Muthusamy V Raman, Cello John P, McQuaid Kenneth R, Shah Janak N
Division of Gastroenterology, University of California, San Francisco, CA, USA.
Dig Dis Sci. 2008 Sep;53(9):2480-5. doi: 10.1007/s10620-007-0151-4. Epub 2007 Dec 20.
Although colonoscopy is used in the diagnostic evaluation of patients with diverticular hemorrhage, data on colonoscopic treatment outcomes are limited. We reviewed records of inpatients undergoing colonoscopy to identify patients that were colonoscopically diagnosed and treated for acute diverticular hemorrhage. Eleven patients with acute diverticular hemorrhage had active bleeding (n = 7) or non-bleeding visible vessel (n = 4) at colonoscopy. Endoclip treatment (preceded by epinephrine injection in 64%) achieved hemostasis in all patients without procedural complications. Patients were discharged within three days without evidence of early rebleeding. During a median follow-up of 15 months, late recurrent bleeding occurred in two patients (18.2%). Colonoscopic treatment of patients with acute diverticular hemorrhage using endoclips appears to be effective and safe, with high rates of immediate and long-term success. Colonoscopy should be considered in patients with suspected acute diverticular hemorrhage, as it may enable definitive therapy without the need for more invasive treatment.
尽管结肠镜检查用于憩室出血患者的诊断评估,但关于结肠镜治疗结果的数据有限。我们回顾了接受结肠镜检查的住院患者记录,以确定经结肠镜诊断并治疗急性憩室出血的患者。11例急性憩室出血患者在结肠镜检查时有活动性出血(n = 7)或无出血可见血管(n = 4)。内镜夹治疗(64%的患者在治疗前注射了肾上腺素)使所有患者止血,且无手术并发症。患者在三天内出院,无早期再出血迹象。在中位随访15个月期间,两名患者(18.2%)发生晚期复发性出血。使用内镜夹对急性憩室出血患者进行结肠镜治疗似乎有效且安全,近期和长期成功率都很高。对于疑似急性憩室出血的患者应考虑进行结肠镜检查,因为它可能无需更具侵入性的治疗就能实现确定性治疗。