Post written by Daniela G. Vinsard, MD and Victoria Gómez, MD, from the Division of Gastroenterology and Hepatology at the Mayo Clinic in Jacksonville, Florida, USA.
Our video case report describes a 90-year-old man with acute painless hematochezia and diverticular bleeding in the sigmoid colon, which was detected on a same day colonoscopy after a rapid colon purge.
Upon careful withdrawal of the colonoscope, active bleeding coming from inside of a diverticulum was noted. The area was tattooed and the colonoscope was exchanged for an adult gastroscope in order to invert the diverticulum with suction and subsequently band it with a variceal banding device, obtaining successful hemostasis.
This video allows the viewer to appreciate the value of performing a very meticulous colonoscopy and careful withdrawal of the colonoscope for bleeding detection and describes the importance of considering different alternatives to achieve hemostasis when a lack of visualization of the bleeding vessel represents a limitation for cauterization or endoclipping.
There is still a lot of value to same day rapid colon purge and same day colonoscopy for the diagnosis and management of suspected lower GI bleeding. The sooner the patient can be treated and the bleeding controlled, the better the outcome and patient’s satisfaction.
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