Diverticular hemorrhage is the most common cause of lower gastrointestinal bleeding in Westernized cultures. Traumatic forces within the lumen of the diverticulum leads to segmental weakening of the associated vasa rectum. Rupture of these vessels into the intestinal lumen results in rectal bleeding ranging from intermittent spotting to life-threatening hematochezia. Due to the usual advanced age and medical comorbidities of these patients, the evaluation and management
of the bleeding patient must proceed in a logical manner to ensure the best outcome. As with other causes of lower gastrointestinal bleed, the physician should obtain a directed history
and physical examination. he primary localization modalities include nuclear scintigraphy, angiography, and colonoscopy. Angiography
and colonoscopy can provide therapeutic intervention at the time of diagnosis while nuclear scintigraphy
is purely diagnostic. This disease can present the most skilled clinician with a challenging diagnostic and therapeutic dilemma. Treatment protocols based on local resources and expertise should be developed to ensure the best possible outcomes for these difficult patients.
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