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Therapeutic Barium Enema for Massive Diverticular Bleeding

Therapeutic Barium Enema for Massive Diverticular Bleeding Abstract The barium enema for the control of massive bleeding from diverticular disease of the colon was evaluated in 22 patients studied prospectively. Twenty-six of 28 acute bleeding episodes were arrested. The two patients who continued to bleed had an emergency colectomy while elective surgery was carried out in three patients after control of bleeding by the barium. The single complication was a laceration of the rectal mucosa by the enema tube. All patients survived. The probable mechanism is a tamponade of the bleeding by barium. Failure to control bleeding suggests that it will not subside spontaneously and in which case, early operative intervention should be undertaken with resection of all colon shown to contain diverticula. References 1. Rigg BM, Ewing MR: Current attitudes on diverticulitis with particular reference to colonic bleeding . Arch Surg 92:321-332, 1966.Crossref 2. Noer RJ, Hamilton JE, Williams DJ, et al: Rectal hemorrhage: Moderate and severe . Ann Surg 155:794, 1962.Crossref 3. Olsen WR: Hemorrhage from diverticular disease of the colon . Amer J Surg 115:247, 1968.Crossref 4. Quinn WC: Gross hemorrhage from presumed diverticular disease of the colon: Results of treatment in 103 patients . Ann Surg 153:851, 1961.Crossref 5. Rives JD, Emmett RO: Melena, a survey of 206 cases . Amer Surg 20:458, 1954. 6. Taylor FW, Epstein LI: Treatment of massive diverticular hemorrhage . Arch Surg 98:505-508, 1969. 7. Asch MJ, Markowitz MJ: Diverticulosis coli: A surgical appraisal . Surgery 62:239, 1967. 8. Griffen JM, Butcher HR, Ackerman LV: Surgical management of colonic diverticulitis . Arch Surg 94:619-626, 1967.Crossref 9. Rosenberg IK, Rosenberg BF: Massive hemorrhage from diverticulae of the colon with demonstration of the source of bleeding . Ann Surg 159:570, 1964.Crossref 10. Wallace RB, Poticha SM, Haber MH: Massive diverticular hemorrhage: Demonstration of the bleeding site . Arch Surg 94:41-43, 1967.Crossref 11. Noveroske RJ: Intracolonic pressures during barium enema examination . Amer J Roentgen 91:852, 1964. 12. Kay S, Choy SH: Results of intraperitoneal injection of barium sulfate contrast medium: An experimental study . Arch Path 59:388-392, 1955. 13. Becker MH, Genieser NB, Clark H: Perforation of the colon during barium enema . New York J Med 67:278, 1967. 14. Jensen GL: Massive hemorrhage from diverticulosis of the colon . Amer J Surg 95:813, 1958.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Therapeutic Barium Enema for Massive Diverticular Bleeding

Archives of Surgery , Volume 101 (4) – Oct 1, 1970

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Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1970.01340280009003
Publisher site
See Article on Publisher Site

Abstract

Abstract The barium enema for the control of massive bleeding from diverticular disease of the colon was evaluated in 22 patients studied prospectively. Twenty-six of 28 acute bleeding episodes were arrested. The two patients who continued to bleed had an emergency colectomy while elective surgery was carried out in three patients after control of bleeding by the barium. The single complication was a laceration of the rectal mucosa by the enema tube. All patients survived. The probable mechanism is a tamponade of the bleeding by barium. Failure to control bleeding suggests that it will not subside spontaneously and in which case, early operative intervention should be undertaken with resection of all colon shown to contain diverticula. References 1. Rigg BM, Ewing MR: Current attitudes on diverticulitis with particular reference to colonic bleeding . Arch Surg 92:321-332, 1966.Crossref 2. Noer RJ, Hamilton JE, Williams DJ, et al: Rectal hemorrhage: Moderate and severe . Ann Surg 155:794, 1962.Crossref 3. Olsen WR: Hemorrhage from diverticular disease of the colon . Amer J Surg 115:247, 1968.Crossref 4. Quinn WC: Gross hemorrhage from presumed diverticular disease of the colon: Results of treatment in 103 patients . Ann Surg 153:851, 1961.Crossref 5. Rives JD, Emmett RO: Melena, a survey of 206 cases . Amer Surg 20:458, 1954. 6. Taylor FW, Epstein LI: Treatment of massive diverticular hemorrhage . Arch Surg 98:505-508, 1969. 7. Asch MJ, Markowitz MJ: Diverticulosis coli: A surgical appraisal . Surgery 62:239, 1967. 8. Griffen JM, Butcher HR, Ackerman LV: Surgical management of colonic diverticulitis . Arch Surg 94:619-626, 1967.Crossref 9. Rosenberg IK, Rosenberg BF: Massive hemorrhage from diverticulae of the colon with demonstration of the source of bleeding . Ann Surg 159:570, 1964.Crossref 10. Wallace RB, Poticha SM, Haber MH: Massive diverticular hemorrhage: Demonstration of the bleeding site . Arch Surg 94:41-43, 1967.Crossref 11. Noveroske RJ: Intracolonic pressures during barium enema examination . Amer J Roentgen 91:852, 1964. 12. Kay S, Choy SH: Results of intraperitoneal injection of barium sulfate contrast medium: An experimental study . Arch Path 59:388-392, 1955. 13. Becker MH, Genieser NB, Clark H: Perforation of the colon during barium enema . New York J Med 67:278, 1967. 14. Jensen GL: Massive hemorrhage from diverticulosis of the colon . Amer J Surg 95:813, 1958.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Oct 1, 1970

References