Original article: Natural history of acute colonic diverticular bleeding: prospective study in 133 consecutive patients

• Published in: Alimentary pharmacology & therapeutics 2010-05, Vol.32 (3)
• Main Authors: Poncet, Gilles, Heluwaert, Frederic, Voirin, David, Bonaz, Bruno, Faucheron, Jean-Luc
• Format: Article
• Language: English
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2010.04362.x

Background: Bleeding recurrence rate after spontaneous haemostasis of colonic diverticular haemorrhage varies in the literature, and a small minority of patients will require endoscopic, radiological or surgical intervention. Aim: To study the natural history of colonic diverticular bleeding in consecutive patients. Methods: We prospectively studied consecutive patients admitted for colonic diverticular bleeding from 1997 to 2005. Data on age, gender, 30-day mortality, therapeutic modality for bleeding management, and subsequent rebleeding were collected. Results: One hundred and thirty three patients (mean age 75.7 years) were recruited. Bleeding stopped spontaneously in 123 patients (92.4%). A more interventional approach was necessary in 10 patients. Thirty-day mortality rate for first bleeding was 2.25%. Out of the 123 patients managed conservatively and submitted to an average follow-up of 47.5 months, 17 (13.8%) presented at least one recurrent diverticular bleeding. Spontaneous haemostasis was obtained in all recurrent cases except one, who died. The estimated bleeding recurrence rate was 3.8% at one year, 6.9% at 5 years and 9.8% at 10 years. Conclusions: The low estimated rebleeding rate and the fact that rebleeding can be treated conservatively in most cases suggest that aggressive approach is not justified.