Open AccessTherapeutic barium enema for bleeding colonic diverticula: Four case series and review of the literature
Author(s) -
Junichi Iwamoto,
Yuji Mizokami,
Koichi Shimokobe,
Takeshi Matsuoka,
Yasushi Matsuzaki
Publication year - 2008
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.14.6413
Subject(s) - medicine , barium enema , colonoscopy , lower gastrointestinal bleeding , enema , gastrointestinal bleeding , gastroenterology , diverticular disease , barium sulfate , surgery , diverticulum (mollusc) , colorectal cancer , chemistry , organic chemistry , cancer
The prevalence of diverticular diseases of the colon, including severe and persistent bleeding in Eastern countries, has increased in the last decades. The bleeding from colonic diverticula is the most common cause of acute lower gastrointestinal bleeding. Herein, we report four cases of severe and persistent bleeding of colonic diverticular disease that could be treated with a high concentration barium enema. These four cases showed a similar pattern of bleeding whose source could not be identified. Colonoscopy revealed fresh blood in the entire colon and many diverticula were noted throughout the colon. No active bleeding source was identified, but large adherent clots in some diverticula were noted. After endoscopic and angiographic therapies failed, therapeutic barium enema stopped the severe bleeding. These patients remained free of re-bleeding in the follow-up period (range 17-35 mo) after the therapy. We report the four case series of therapeutic barium enema and reviewed the literature pertinent to this procedure.