Conclusions
Eighty-three patients with bleeding colonic diverticulosis were treated between 1966 and 1972 in two Los Angeles hospitals. Of these, 86 per cent were more than 60 years old, and there was a high incidence of associated disease. The majority of patients (79 per cent) were treated medically, with a mean blood replacement of 3.4 units. There were no deaths in the patients treated conservatively; however, 25 per cent had recurrent bleeding episodes after discharge. The 18 patients who needed surgery had an average blood replacement of 8.0 units, and there were four deaths. Rebleeding in the postoperative period occurred in nine of 11 patients who did not have resection of all chronic diverticula. Three of the four deaths followed second procedures for continued bleeding.
Conservative management is successful for the majority of patients with bleeding diverticulosis. When surgery is indicated, all segments of the colon bearing diverticula should be resected to prevent postoperative rebleeding.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Albo RJ, Grimes OF, Dunphy JE: Management of massive lower gastrointestinal hemorrhage. Am J Surg 112: 264, 1966
Behringer GE, Albright NL: Diverticular disease of the colon: A frequent cause of massive rectal bleeding. Am J Surg 125: 419, 1973
Cate WC Jr: Colectomy in the treatment of massive melena secondary to diverticulosis: Report of a case. Ann Surg 137: 558, 1953
Deddish MR, Hertz RE: Colotomy and coloscopy in the management of mucosal polyps and cancer of the colon. Am J Surg 90: 846, 1955
Gieske JC, Kahn PC, Moran JM: Arterial ligation for control of colonic diverticular hemorrhage. JAMA 217: 1100, 1971
Hoar CS, Bernhard WF: Colonic bleeding and diverticular disease of the colon. Surg Gynecol Obstet 99: 101, 1954
Kleinfeld G, Gump FE: Complications of colotomy and polypectomy. Surg Gynecol Obstet 111: 726, 1960
Knight CD: Massive hemorrhage from diverticular disease of the colon. Surgery 42: 853, 1957
Koch J: Über einfach entzündliche Stricturen des Dickdarms. Langenbecks Arch Chir 70: 876, 1903
Kunath CA: Massive bleeding from diverticulosis of the colon. Am J Surg 91: 911, 1956
Maynard EP III, Voorhees AB Jr: Arterial hemorrhage from a large bowel diverticulum. Gastroenterology 31: 210, 1956
Noer RJ: Hemorrhage as a complication of diverticulitis. Ann Surg 141: 674, 1955
Noer RJ, Hamilton JE, Williams DJ, et al: Rectal hemorrhage: Moderate and severe. Ann Surg 155: 794, 1962
Olsen WR: Hemorrhage from diverticular disease of the colon: The role of emergency subtotal colectomy. Am J Surg 115: 247, 1968
de Quervain F: Diverticulosis and diverticulitis of the large intestine. Practitioner 118: 352, 1927
Quinn WC: Gross hemorrhage from presumed diverticular disease of the colon: Results of treatment in 103 patients. Ann Surg 153: 851, 1961
Ramanath HK, Hinshaw JR: Management and mismanagement of bleeding colonic diverticula. Arch Surg 103: 311, 1971
Rosch J, Gray RK, Grollman JH Jr, et al: Selective arterial drug infusions in the treatment of acute gastrointestinal bleeding: A preliminary report. Gastroenterology 59: 341, 1970
Sauer WG: Diverticulitis of the colon. Minn Med 31: 365, 1948
Telling WH, Gruner OC: Acquired diverticula diverticulitis, and peridiverticulitis of the large intestine. Br J Surg 4: 468, 1917
Author information
Authors and Affiliations
About this article
Cite this article
Parsa, F., Gordon, H.E. & Wilson, S.E. Bleeding diverticulosis of the colon: A review of 83 cases. Dis Colon Rectum 18, 37–41 (1975). https://doi.org/10.1007/BF02587238
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02587238