Endosc Int Open 2015; 03(05): E523-E528
DOI: 10.1055/s-0034-1392215
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Risk factors for early rebleeding after endoscopic band ligation for colonic diverticular hemorrhage

Takashi Ikeya
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Naoki Ishii
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Kaoru Nakano
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Fumio Omata
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Yuto Shimamura
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Mai Ego
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Koichi Takagi
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Kenji Nakamura
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Katsuyuki Fukuda
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
,
Yoshiyuki Fujita
Department of Gastroenterology, St. Luke’s International Hospital, Tokyo, Japan
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Weitere Informationen

Publikationsverlauf

submitted 07. Januar 2015

accepted after revision 13. April 2015

Publikationsdatum:
12. Juni 2015 (online)

Background and study aims: Endoscopic band ligation (EBL) has been used for hemostasis of colonic diverticular hemorrhage. However, early rebleeding (< 30 days after EBL) has been reported in some cases. The aim of this study was to elucidate risk factors for early rebleeding after EBL in treatment of colonic diverticular hemorrhage.

Patients and methods: A total of 101 patients with definite diverticular hemorrhage treated using EBL from June 2009 to October 2014 were included in the retrospective cohort study and divided into rebleeding and non-rebleeding groups, depending on the presence or absence of early rebleeding. Patients’ ages, comorbid diseases, stigmata of recent hemorrhage (SRH) [active bleeding (AB), non-bleeding visible vessel (NBVV), or adherent clot (AC)], locations of bleeding diverticula, and eversions of the diverticula after EBL were retrospectively evaluated in each group.

Results: Early rebleeding occurred in 15 cases. The median time (range) of early rebleeding occurrence was 5 days (range, 2 h to 26 days). Early rebleeding could be managed conservatively and/or endoscopically, except in one case in which surgery was done. Multivariate analysis revealed that age under 50 (adjusted OR, 8.7; 95 % CI 1.6 – 52.5; P = 0.014) and AB (adjusted OR, 4.21; 95 % CI 1.15 – 18.1; P = 0.03) were shown to be significant risk factors. The right side of the colon carried less risk than did the left side (adjusted OR, 0.21; 95 % CI 0.04 – 0.84; P = 0.028).

Conclusions: Younger age, AB of SRH, and leftsided lesions were identified as the risk factors for early rebleeding after EBL in the treatment of colonic diverticular hemorrhage.