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[Sigmoid colon diverticular bleeding in a 75-year-old woman]

Jeoung Ho Choi1, Young Sook Park, Chae Young Lim

  • 1Department of Internal Medicine, Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea. twentees@eulji.ac.kr

The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|February 25, 2009
PubMed

Insights

Diverticular bleeding, a common cause of hematochezia, can be massive and recurrent. This case highlights left-sided diverticular bleeding in Korea, a rare presentation, successfully treated with surgery.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Diverticular bleeding is the most frequent cause of brisk hematochezia in Western nations, affecting 15% of individuals with diverticulosis.
  • While left-sided colonic diverticulosis is prevalent in Western countries, right-sided diverticulosis is more common in Korea, with left-sided bleeding reports being infrequent.

Observation:

  • A 75-year-old female presented with hematochezia and dizziness, indicative of significant blood loss.
  • Her medical history included two prior treatments for diverticular bleeding, one complicated by diverticulitis.
  • Colonoscopy revealed extensive diverticulosis in the sigmoid colon up to the splenic flexure, with active fresh blood clots observed.

Findings:

  • The patient was diagnosed with recurrent massive diverticular bleeding originating from the sigmoid colon.
  • The bleeding was exclusively confined to the left colon, a rare occurrence in the Korean population.

Implications:

  • This case underscores the possibility of left-sided diverticular bleeding, even in regions where right-sided diverticulosis is more common.
  • Prompt diagnosis and surgical intervention, such as laparoscopic left hemicolectomy, are crucial for managing recurrent massive diverticular bleeding.
  • Further research into geographical variations of diverticular disease and bleeding patterns is warranted.

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