Abstract Text
A 50-years-old man presented with rectal bleeding and anemia. CT scan suggested left colic diverticular bleeding. During the first colonoscopy a suspicious diverticulum was clipped. Three days later, the patient had recurrent bleeding and syncope. A second colonoscopy identified the bleeding diverticulum, treated with 5 endoclips. Rebleeding the following day required a third colonoscopy with hemostasis using an over-the-scope clip (OTSC). After 4 days the peridiverticular mucosa grasped by the OTSC bled and was treated with coagrasper. Recurrent bleeding required two superselective arterial embolizations, which finally stopped it after 13 days. Diverticular bleeding can be refractory despite repeated endoscopic and radiological interventions. The use of OTSC as a rescue therapy can fail, as bleeding in the responsible diverticulum may exceed its haemostatic capacity.