Management and Mismanagement of Bleeding Colonic Diverticula

Hassan K. Ramanath, MD; J. Raymond Hinshaw, MD
Arch Surg. 1971;103(2):311-314. doi:10.1001/archsurg.1971.01350080227036.
Text Size: A A A
Published online

A study of 100 patients experiencing 144 episodes of bleeding from colonic diverticula was made. In 16, colonic bleeding was the first manifestation of diverticular disease. Surprisingly, 42 had only black, tarry stools while 58 had bright red rectal bleeding. Sixty bleeding episodes (41.5%) were massive and necessitated transfusion of more than 1,500 ml of blood. Fifty-three (37%) did not lead to transfusion. Only five were associated with signs of acute diverticulitis. Although only 19 patients, all initially treated with a medical regimen, required operation, they had often bled too much (average 5,260 ml), too long and too often before operative intervention. Frequently the wrong operation was performed. This study demonstrates that local resection is adequate only if disease is confined to a single area which is bleeding. When disease is extensive, total abdominal colectomy with ileoproctostomy is the procedure of choice.


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.