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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(01): E50-E55
DOI: 10.1055/a-1630-6175
Original article

Identification of diverticular bleeding needs early colonoscopy rather than preparation

Akira Mizuki
1   Department of Internal Medicine, Tokyo Saiseikai Central Hospital,Tokyo, Japan
,
Masayuki Tatemichi
2   Department of Community Health, Tokai University School of Medicine, Isehara, Japan
,
Atsushi Nakazawa
1   Department of Internal Medicine, Tokyo Saiseikai Central Hospital,Tokyo, Japan
,
Nobuhiro Tsukada
1   Department of Internal Medicine, Tokyo Saiseikai Central Hospital,Tokyo, Japan
,
Hiroshi Nagata
3   Department of Internal Medicine, Keiyu Hospital, Yokohama, Japan
,
Takanori Kanai
4   Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan
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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.



Publication History

Received: 13 December 2020

Accepted: 02 August 2021

Article published online:
14 January 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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