Lower gastrointestinal bleeding of diverticular cause

The efficient treatment of lower gastrointestinal bleeding of diverticular cause was made possible by the recent progress in medical imaging. A severe bleeding can appear in approximately 5 % of the patients with colonic diverticular disease. In 70% of the cases the bleeding stops spontaneously, requiring only conservative treatment. If the bleeding persists, the elective methods of treatment are endoscopic hemostasis and embolization .

Retrospective study which included 31 patients admitted in the Surgery Ward of the Bucharest Clinical Emergency Hospital between January 2014 and June 2015 with the diagnosis of diverticular colonic disease which complicated with lower gastrointestinal bleeding.

During the 18 months of the study, 31 patients presented with lower gastrointestinal bleeding of diverticular cause.The average age of the patients was 78,1 with a male/female ratio of 1:1,38.The average value of the hemoglobin was 9,6 g/dl. In 26 of the cases emergency colonoscopy was performed and 22 presented active bleeding or bleeding stigmata. Endoscopic hemostasis was performed on 4 patients,3 patients needed angiographic control with the embolization of the arterial source and 2 patients needed emergency colectomy to stop the acute bleeding. The average time of hospitalization was 5,7 days. No death was registered in the studied lot.

Colonoscopy plays an important roll in the diagnosis and therapeutic management of the lower gastrointestinal bleeding of diverticular cause.Conservative treatement is elective , surgery only being needed in case of complications or recurrence.

Diverticulosis,lower gastrointestinal bleeding,treatement