Successful endoscopic hemostasis compared to transarterial embolization in patients with colonic diverticular bleeding

Takashi Ueda, Hideki Mori, Tatsuya Sekiguchi, Yusuke Mishima, Masaya Sano, Erika Teramura, Ryutaro Fujimoto, Motoki Kaneko, Hirohiko Nakae, Mia Fujisawa, Masashi Matsushima, Hidekazu Suzuki

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Transarterial embolization (TAE) is performed in patients with colonic diverticular bleeding after difficult endoscopic hemostasis or rebleeding. A total of 375 patients with hematochezia at our hospital from 1 April 2016 to 31 March 2020 were retrospectively analysed. Firstly, we compared the group in which hemostasis was achieved by endoscopy alone with the group that eventually underwent TAE. Secondly, we compared the group in which hemostasis was achieved by endoscopy alone, with the group switched to TAE after endoscopic hemostasis failed. The group that eventually underwent TAE had a higher shock index and lower Alb and PT% than the endoscopic hemostasis group. The shock index was correlated with Alb and PT%. When the cut-off value for the shock index was defined as more than 0.740, an OR of 9.500, a positive predictive value (PPV) of 40.0%, a negative predictive value (NPV) of 93.4%, and an accuracy of 80.3% were obtained for predicting a switch to TAE treatment. The greatest risk for TAE was the presence of shock and extravasation on contrast-enhanced CT. A switch to TAE treatment was likely when the shock index was more than 0.740. TAE should be considered in cases with a high shock index and showing extravasation on contrast-enhanced CT.

Original languageEnglish
Pages (from-to)283-289
Number of pages7
JournalJournal of Clinical Biochemistry and Nutrition
Volume70
Issue number3
DOIs
Publication statusPublished - 2022
Externally publishedYes

Keywords

  • TAE
  • diverticular bleeding
  • extravasation on contrast-enhanced CT examination
  • shock index

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Clinical Biochemistry

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