Endoscopic detachable snare ligation: a new treatment method for colonic diverticular hemorrhage

Endoscopy. 2015 Nov;47(11):1039-42. doi: 10.1055/s-0034-1392204. Epub 2015 May 28.

Abstract

Background and study aims: Colonic diverticular hemorrhage is the most common cause of lower intestinal bleeding. We tried to develop a convenient and reliable hemostatic method, endoscopic detachable snare ligation (EDSL), to treat diverticular hemorrhage and retrospectively explored its safety and efficacy.

Patients and methods: The definitive bleeding diverticulum was ligated with a detachable snare, instead of a rubber band, in a procedure similar to endoscopic band ligation. Removal of the scope to attach a ligation device and reinsertion for treatment are not needed in this method.

Results: From November 2013 to September 2014, EDSL was used to treat 8 patients with colonic diverticular hemorrhage. The mean procedure time required for hemostasis after identification of the bleeding diverticulum was 5 ± 2 minutes. Sustained hemostasis was achieved in 7 patients (88 %), and early rebleeding occurred in 1 patient, in whom the applied suction seemed inadequate. No complications occurred in any patient.

Conclusions: EDSL may be a safe and effective treatment for colonic diverticular hemorrhage. However, additional studies are warranted to confirm these initial exploratory data.

Publication types

  • Video-Audio Media

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colonoscopy / instrumentation
  • Colonoscopy / methods*
  • Diverticulum, Colon / complications*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Endoscopic / instrumentation
  • Hemostasis, Endoscopic / methods*
  • Humans
  • Ligation / instrumentation
  • Ligation / methods
  • Male
  • Middle Aged
  • Treatment Outcome