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Right-sided colonic diverticular disease as a source of lower gastrointestinal bleeding
1Department of Surgery, National University Hospital, National University of Singapore, Republic of Singapore, Hong Kong.
The American Surgeon
|April 6, 1999
Summary
Right-sided colonic diverticular disease, though uncommon, can cause significant lower gastrointestinal bleeding. This study highlights its presentation and management, with surgery often necessary for persistent hemorrhage.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Right-sided colonic diverticular disease is an uncommon entity, particularly in Western populations.
- It can present as significant lower gastrointestinal bleeding, often requiring medical intervention.
Purpose of the Study:
- To report on a series of 25 cases of bleeding right colon diverticulosis.
- To discuss the presentation and management strategies for this condition.
Main Methods:
- Retrospective review of 190 patients with suspected acute lower gastrointestinal bleeding.
- Selection of 25 patients diagnosed with right-sided diverticular bleeding from 1988 to 1994.
- Analysis of patient demographics, clinical presentation, colonoscopic findings, and treatment outcomes.
Main Results:
- 25 out of 57 (44%) patients with diverticular bleeding had right-sided disease.
- Hypertension was a common comorbidity (64%).
- 60% required blood transfusion; 12% showed active bleeding on colonoscopy. Spontaneous cessation occurred in 64%, while 36% needed surgery (right hemicolectomy) for persistent bleeding.
Conclusions:
- Right-sided colonic diverticular disease is a treatable cause of lower gastrointestinal bleeding.
- While many cases resolve spontaneously, surgical intervention is crucial for refractory bleeding.
- Conservative management leads to shorter hospital stays compared to surgery.