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Direct clipping method with a repositioning endoscopic clip for colonic diverticular bleeding
Digestive Endoscopy ( IF 5.0 ) Pub Date : 2020-02-26 , DOI: 10.1111/den.13639 Sho Suzuki 1 , Mitsuru Esaki 1 , Ryoji Ichijima 1
Digestive Endoscopy ( IF 5.0 ) Pub Date : 2020-02-26 , DOI: 10.1111/den.13639 Sho Suzuki 1 , Mitsuru Esaki 1 , Ryoji Ichijima 1
Affiliation
COLONIC DIVERTICULAR BLEEDING (CDB) is a common disease that sometimes causes severe anemia and hemorrhagic shock. Endoscopic hemostasis is the key to managing CDB, and specialized endoscopic techniques and devices have recently been proposed. Each method, however, has inherent limitations, including colonoscope reinsertion and high cost. Thus, a definite method has not been determined. A repositioning endoscopic clip is a unique device that permits smooth and repeated opening and closing of the tip and may help achieve hemostasis in a small working space. We present a novel endoscopic clipping method for acute CDB that uses a repositioning endoscopic clip (Fig. 1 and Video S1). An 82-year-old woman presented with massive hematochezia. Colonoscopy revealed diverticula with fresh coagula at the ascending colon. After coagula removal, active bleeding occurred at the diverticula base (Fig. 2a). First, a repositioning endoscopic clip (SureClip Mini, Micro-Tech Co., Nanjing, China) was gently and carefully inserted into the diverticula, with the tip closed. Next, the diverticula aperture was widened by the inserted clip, and the bleeding point and vessel at the base of the diverticula were observed (Fig. 2b).
更新日期：2020-02-26
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