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Background/Aims: Colonic diverticular bleeding can stop spontaneously or be stopped by endoscopic hemostasis. We analyzed the clinical and colonoscopic features of patients with colonic diverticular bleeding to establish the predictive factors for rebleeding. Methods: A total of 111 patients (median age, 72 years) with colonic diverticular bleeding in Aso Iizuka Hospital between April 2007 and July 2010 were enrolled. Age, sex, body mass index (BMI), comorbidity, medication, location of bleeding, colonoscopic findings and hemostatic methods were analyzed retrospectively from the hospital records. Results: The most common sites of bleeding were the ascending (39.6%) and sigmoid (29.7%) colon. Overt rebleeding occurred in 30 patients (27.0%). Spontaneous hemostasis was seen in 81 patients (73.0%), and endoscopic hemostatic treatment was performed in 30 patients. The BMI in the patients with colonic diverticular rebleeding was significantly higher than in patients without rebleeding. Colonoscopic findings of actively bleeding or nonbleeding visible vessels in the responsible diverticula were more frequent in the group with rebleeding. Conclusions: A higher BMI and colonoscopic findings of actively bleeding or nonbleeding visible vessels can be used as predictive factors for colonic diverticular rebleeding. Patients with such findings should be carefully followed up after hemostasis of the initial colonic diverticular bleeding.

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참고문헌 (1)

참고문헌 신청
Kubo A / 1985 / Studies on complications of diverticular disease of the colon / Jpn J Med 24 : 39 ~ 43 | 2. [학술지(정기간행물)] - Yamada A / 2008 / Assessment of the risk factors for colonic diverticular hemorrhage / Dis Colon Rectum 51 : 116 ~ 120 | 3. [학술지(정기간행물)] - Foutch PG / 1995 / Diverticular bleeding: are nonsteroidal anti-inflammatory drugs risk factors for hemorrhage and can colonoscopy predict outcome for patients? / Am J Gastroenterol 90 : 1779 ~ 1784 | 4. [학술지(정기간행물)] - Peura DA / 1997 / The American College of Gastroenterology Bleeding Registry: preliminary findings / Am J Gastroenterol 92 : 924 ~ 928 | 5. [학술지(정기간행물)] - Machicado GA / 2006 / Endoscopic diagnosis and treatment of severe lower gastrointestinal bleeding / Indian J Gastroenterol 25 (Suppl 1) : S43 ~ S51 | 6. [학술지(정기간행물)] - Strate LL / 2009 / Obesity increases the risks of diverticulitis and diverticular bleeding / Gastroenterology 136 : 115 ~ 122 | 7. [학술지(정기간행물)] - Jensen DM / 2000 / Urgent colonoscopy for the diagnosis and treatment of severe diverticular hemorrhage / N Engl J Med 342 : 78 ~ 82 | 8. [학술지(정기간행물)] - Ramirez FC / 1996 / Successful endoscopic hemostasis of bleeding colonic diverticula with epinephrine injection / Gastrointest Endosc 43 (2 Pt 1) : 167 ~ 170 | 9. [학술지(정기간행물)] - Savides TJ / 1994 / Colonoscopic hemostasis for recurrent diverticular hemorrhage associated with a visible vessel: a report of three cases / Gastrointest Endosc 40 : 70 ~ 73 | 10. [학술지(정기간행물)] - Simpson PW / 2004 / Use of endoclips in the treatment of massive colonic diverticular bleeding / Gastrointest Endosc 59 : 433 ~ 437 | 11. [학술지(정기간행물)] - Farrell JJ / 2003 / Treatment of bleeding colonic diverticula by endoscopic band ligation: an in-vivo and ex-vivo pilot study / Endoscopy 35 : 823 ~ 829 | 12. [학술지(정기간행물)] - Ishii N / 2010 / Endoscopic band ligation with a water-jet scope for the treatment of colonic diverticular hemorrhage / Dig Endosc 22 : 232 ~ 235 | 13. [학술지(정기간행물)] - Lewis M / 2008 / Bleeding colonic diverticula / J Clin Gastroenterol 42 : 1156 ~ 1158 | 14. [학술지(정기간행물)] - Meyers MA / 1976 / Pathogenesis of massively bleeding colonic diverticulosis: new observations / AJR Am J Roentgenol 127 : 901 ~ 908 | 15. [학술지(정기간행물)] - Kethu SR / 2003 / Images in clinical medicine: bleeding colonic diverticulum / N Engl J Med 349 : 2423 ~ google schola

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