Surgical Treatment of Colonic Diverticular Bleeding

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  • Ota Gaku
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Koinuma Koji
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Honma Yuko
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Oshiro Kenichi
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Sadatomo Ai
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Naoi Daishi
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Inoue Yoshiyuki
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Horie Hisanaga
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Mimura Toshiki
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Sata Naohiro
    Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University
  • Morikawa Takaaki
    Division of Gastroenterology, Department of Medicine, Jichi Medical University
  • Yamamoto Hironori
    Division of Gastroenterology, Department of Medicine, Jichi Medical University

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Other Title
  • 当院における大腸憩室出血の外科治療症例の検討

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<p>Objective: To retrospectively review the treatment of patients with colonic diverticular bleeding in our institution, and to evaluate clinical characteristics of patients who underwent surgical treatment.</p><p>Methods: A total of 194 patients with colonic diverticular bleeding from January 2010 to April 2020 were enrolled in this study.</p><p>Results: Seven (4%) patients underwent surgical treatment. Of these, five had endoscopic treatment followed by surgery, and two had endoscopic and interventional radiology treatment followed by surgery. All patients required blood transfusions to treat hemodynamic shock. Bleeding was in the ascending colon and right hemicolectomy was performed in all patients. One female developed re-bleeding post-operatively three times every three years, and was treated non-operatively. She had multiple diverticula in both the right and left colons, and was taking anticoagulants.</p><p>Conclusion: Patients with colonic diverticular bleeding were treated according to the treatment guidelines. Although some patients were in poor condition, their post-operative course was uneventful. While subtotal colectomy is recommended for patients whose bleeding source is unknown in the guidelines, treatment decisions including the range of excision must be made individually depending on the patient's condition (age, activities and comorbidities).</p>

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