PMID: 8946992Dec 1, 1996Paper

Diverticular bleeding and the pigmented protuberance (sentinel clot): clinical implications, histopathological correlation, and results of endoscopic intervention

The American Journal of Gastroenterology
P G Foutch, K Zimmerman

Abstract

Over a 3-yr period, we performed colonoscopy on five patients (mean age 71 yr) in whom a specific diverticulum that contained a pigmented protuberance (PiP) was unequivocally identified as the cause for hemorrhage. Four of these individuals had endoscopic bipolar cauterization of the PiP, and two patients had surgery. To (1) determine the clinical significance of an intradiverticular PiP, (2) correlate endoscopic features of a PiP with histopathological findings and, (3) assess results of endoscopic treatment for affected patients with lower GI bleeding. Medical charts were reviewed to garner data and assess outcome for patients. The bleeding diverticulum in one surgical case was detected in the resected specimen, and histological examination was performed. The mean number of transfusions, bleeding days, and lowest hemoglobin concentration before definitive treatment was 4.8, 3.4, and 8.4 gm%, respectively. All patients rebled before treatment. In all instances, the PiP projected through the neck of the diverticulum, which was actively bleeding in two patients. Endoscopic bipolar cautery directed at the PiP achieved permanent hemostasis in three of four subjects (75%) (morbidity 0%). Endoscopic therapy failed in one subject, an...Continue Reading

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Related Papers

Zhonghua bing li xue za zhi Chinese journal of pathology
Jin ZhangJie Ma
Archives of Otolaryngology--head & Neck Surgery
Nicolas LeboulangerEréa-Noël Garabedian
Archives of Otolaryngology--head & Neck Surgery
D J VerretOrval Brown
© 2021 Meta ULC. All rights reserved