[Severe lower gastrointestinal tract bleeding due to diverticulosis].
BACKGROUND
Diverticulosis is the most frequent cause of lower gastrointestinal (GI) bleeding in adults in western countries. The aims of the present study were to analyze: 1) the diagnostic and therapeutic management of patients with severe lower GI bleeding due to diverticulosis; 2) associated morbidity and mortality; 3) the need for surgery, and 4) bleeding recurrence rates after hospital discharge.


METHODS
Were retrospectively reviewed 42 patients with severe lower GI bleeding due to diverticulosis. Patients with rectorrhagia requiring transfusion of at least three packed red blood cell units and those with a decrease in hematocrit of 10 points or more were included. As a control group, we used 133 patients with severe lower GI hemorrhage due to causes other than colonic diverticular disease.


RESULTS
All patients were stabilized with conservative measures except one who required emergency surgery. Colonoscopy was performed in 39 patients and the most frequent finding consisted of recent signs of bleeding independently of whether colonoscopy was performed early or was delayed. Endoscopic treatment with Argon laser electrocoagulation was performed in one patient. Bleeding recurrence after hospital discharge occurred in 13 patients (31%); of these, seven (16%) required hospital readmission.


CONCLUSIONS
Severe lower GI bleeding due to diverticulosis can usually be resolved with conservative treatment although the percentage of bleeding recurrence is high. Early endoscopy is not as important as in the remaining causes of severe lower GI bleeding.
Ríos Zambudio
Antonio
A
Servicio de Cirugía General y del Aparato Digestivo I, Departamento de Cirugía, Hospital Universitario Virgen de la Arrixaca, Murcia, España. arzrios@teleline.es
Montoya Tabares
Mariano J
MJ
Rodríguez González
José Manuel
JM
Febrero Sánchez
Beatriz
B
Albaladejo Meroño
Aquilino
A
Molina
Joaquin
J
Parrilla Paricio
Pascual
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003113:Colonoscopy; D003131:Combined Modality Therapy; D043963:Diverticulosis, Colonic / Q000150:complications* / Q000175:diagnosis; D017707:Erythrocyte Transfusion; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery / Q000628:therapy; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D012007:Rectum; D012008:Recurrence; D012189:Retrospective Studies