Clin Endosc.  2021 Mar;54(2):256-260. 10.5946/ce.2020.081.

Utility of the Gel Immersion Method for Treating Massive Colonic Diverticular Bleeding

• Yamamoto K
• Shiratori Y
• Ikeya T

• KMID: 2514181
• DOI: http://doi.org/10.5946/ce.2020.081

Abstract

Background/Aims
In Asia, right-sided diverticular bleeding is more common than that of the left side. It often causes massive bleeding and difficulties in identifying the stigmata of recent hemorrhage (SRH) of colonic diverticular bleeding (CDB). This case series demonstrates the efficacy of the gel immersion method using OS-1 Jelly (Otsuka Pharmaceuticals Factory, Tokushima, Japan) in patients with CDB.
Methods
This retrospective case series analyzed data of patients with CDB who underwent the gel immersion method from April 2016 to February 2020 at St. Luke’s International Hospital, Japan. All patients diagnosed with CDB who underwent the gel immersion method were included. We collected data on the site of bleeding, identification of SRH, and efficacy of the method from the electronic medical records.
Results
A total of 9 patients (including 7 with right-sided CDB) underwent gel immersion method and were included in this study. SRH were successfully found in 66.7% (6/9) of patients. Moreover, effective hemostasis was achieved in 85.7% (6/7) of patients with right-sided CDB. There were no adverse events.
Conclusions
The gel immersion method was found to be effective, especially for massive right-sided CDB.

Keyword

Diverticular diseases; Diverticulum; Gastrointestinal hemorrhage

Figure

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  Fig. 1. (A) Colonoscopic view of massive bleeding in the right colon. (B) The gel immersion method successfully washed out the massive clots and revealed diverticula with adherent clot. (C) Peeling of the clot exposed a non-bleeding visible vessel.

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