Abstract
Background and study aims When patients present with acute colonic diverticulum bleeding (CDB), a colonoscopy
is performed to identify stigmata of recent hemorrhage (SRH), but valuable time can
be lost in bowel preparation. This study retrospectively examined groups of patients
who either had a standard pre-colonoscopy regimen or no preparation.
Patients and methods This study compared data from 433 patients who either followed a lengthy regimen of
bowel preparation (prepared group, 266 patients) or had no preparation (unprepared
group, 60 patients). We compared the association between time (hours) between admission
before starting a colonoscopy (TMS) and identification of SRH using a chi-square test.
Results In 48 of 60 cases (80.0 %) in the unprepared group, a total colonoscopy was performed
and the time to identify SRH was decreased. The respective rates of SRH identification
in the unprepared and prepared groups were 55.2 % (16/29) vs. 46.7 % (7/15) if the
TMS was < 3 hours; 47.1 % (8/7) vs. 36.8 % (35/95) in 3 to 12 hours; 0 % (0/3) vs.
22.0% (13/59) in 12 to 18 hours; and 21.8 % (3/11) vs. 20.6% (42/204) in > 18 hours.
There were no significant differences between the two groups. However, the SRH identification
rates before and after 12 hours were 42.3 % (66/156) and 20.9 % (58/277) (P < 0.001).
Conclusions Our data suggest that the bowel preparation method before colonoscopy is an independent
variable predicting success in identifying SRH among patients with CDB. Decreasing
the time before colonoscopy to no more than 12 hours after admission played an important
role in identifying SRH.
