OTS-clip for bleeding colon diverticulum

Résumé fourni par la source

Aims Colonic diverticular bleeding is frequent cause of lower GI bleeding in adults. Majority of bleeding resolves with spontaneous hemostasis. Our aim is to present OTS-clip as a safe and effective endoscopic therapy of achieving hemostasis. Methods For many years endoscopic hemostasis for colonic diverticular bleeding mostly included TTS (through the scope clips) and EBL (endoscopic band ligation). During past years OTS-clip is emerging as a first line therapy for GI bleeding in upper GI tract. Despite that there is low number of case reports and studies for use of OTS-clip in lower GI bleeding [ 1 ] [ 2 ] [ 3 ] [ 4 ]. Results We present a case report of 65-year old woman who initally presented with hematochesia. During hospitalization index colonoscopy was performed and two diverticulum in ascending colon near hepatic flexure were noticed without active bleeding or SRH (stigmata of recent hemorrhage). Patient underwent radiological and scintigraphy with inconclusive results. She had no further bleeding and was discharged 4 days later. After 7 days patient presented again with hematochesia. We performed urgent colonoscopy and in one of the previously noted diverticulum was noticed a non bleeding vessel. After marking the spot of diverticulum OTS-clip (14/6t) was mounted and successfully deployed. Patient had an uneventful recovery and was discharged 3 days later. At 3 month follow-up she had no recurrent GI bleeding. Conclusions Even though there is small number of case reports for use of OTS-clip for lower GI bleeding, in all published data OTS-clip showed as safe and effective therapy for bleeding diverticular disease and should be considered in such cases. Publication History Article published online: 14 April 2023 © 2023. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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