| Theme |
Therapeutic Colonoscopy -- Recent Advances |
| Title |
Endoscopic Hemostasis for Hemorrhagic Lesions of Large Intestine |
| Author |
Kiyonori Kobayashi |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Kaoru Yokoyama |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Miwa Sada |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Tomoe Katsumata |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Katsunori Saigenji |
Department of Gastroenterology, Kitasato University East Hospital |
| Author |
Shigeru Yoshizawa |
Department of Gastroenterology, Odawara Municipal Hospital |
| [ Summary ] |
Those hemorrhagic lesions of the large intestine as that result from endoscopic hemostasis are brought about by hemorrhaging from diverticular disease, angiodysplasia, radiation proctitis or intestinal ulcers associated with inflammatory bowel disease and other causes. Methods for endoscopic hemostasis are divided into four groups, (1) mechanical hemostasis, (2) heat coagulation, (3) endoscopic injection or (4) spraying of hemostatic drugs. Of these methods, endoscopic clipping is mainly used and is useful for colonic lesions with localized bleeding, such as in visible vessels. Endoscopic hemostasis with the clipping method for diverticular hemorrhaging was successful in 97 % of our cases. Endoscopic argon plasma coagulation (APC) is useful for the treatment of hemorrhagic vascular diseases such as angiodysplasia or radiation proctitis. It is very important to choose most appropriate endoscopic hemostasis method for basic diseases and determined by the characteristics of bleeding as evaluated from endoscopic findings. During examination of patients with hemorrhagic lesions of the large intestine, the general condition of patients should be evaluated while in contact with radiologists and surgeons. Interventional radiology or emergency surgery should be promptly performed on patients in whom hemorrhaging cannot be controlled by endoscopic hemostasis. |