Resected Colonic Diverticula with Massive Bleeding Located with Angiography

Toshimasa Yamaguchi, Tomoaki Urakawa, Yoshihiro Nishida, Mitsuharu Nakamoto, Naoto Kawakita, Yukio Nishio, Katsunori Kawaguchi, Kiyoshi Uematsu

Department of Surgery, Kobe Rosai Hospital

Hemorrhage from colonic diverticula is self-limiting in the majority of cases; therefore a conservative attitude to therapy has been recommended. We experienced a case of massive bleeding of a colonic diverticulum, which required resection of the colon. A 76-year-old man with a history of alcoholism was admitted to our hospital for acute pancreatitis (serum amylase 2,056 u/l urinary amylase 21,850 u/l and was treated by conservative therapy. Bleeding began and stopped spontaneously. A barium enema showed two diverticula in the ascending segment and many in the sigmoid segment, which were suspected as the source of bleeding. A second massive hemorrhage occurred, and was uncontrollable. Then right hemicolectomy was undertaken after selective mesenteric arteriography revealed the diverticular bleeding in the ascending colon. He died of pneumonia and multiple organ failure following pancreatitis. Arteriography accurately located the site of hemorrhage, and effective surgical therapy was possible.

Key words
colonic diverticular bleeding

Reprint requests
Toshimasa Yamaguchi First Department of Surgery, Kobe University, School of Medicine
7-5-2 Kusunokicho, Chuo-ku, Kobe, 650 JAPAN

Accepted
February 14, 1990

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