Barium impaction therapy with balloon occlusion for deep colonic diverticular bleeding: a three-case series

Background and aims: In hemostasis for colonic diverticular bleeding, the incidence of recurrent bleeding is higher in deep colonic diverticulum than in shallow. We aimed to improve and evaluate barium impaction therapy using an enteroscopic overtube with balloon. Patients and method: We performed barium impaction therapy in three patients with a diagnosis of deep colonic diverticular bleeding. The tip of the overtube was inserted to reach the cecum using the conventional method. After deflating the colon, the enteroscope was removed. The balloon in the tube was inflated, followed by barium filling via the tube. Sufficient pressure was applied by ensuring no regurgitation into the small intestine side. The entire colon was continuously filled with barium in stages. Results: Post-treatment bleeding was controllable without adverse events in all three patients. Conclusion: This novel barium impaction therapy using an enteroscopic overtube with balloon was effectively performed without adverse events.