2021 Volume 41 Issue 6 Pages 403-407
Purpose: To evaluate the outcomes of colonic diverticular bleeding and clarify the indications for surgery. Materials and Methods: This retrospective study involved the data of 286 patients with colonic diverticular bleeding who were treated at our institution. Among the 110 patients in whom the source of bleeding was identifiable, the bleeding resolved without surgery in 74 patients and the remaining 36 patients required surgery for the control of bleeding. The clinical characteristics and outcomes were compared, and the surgical outcomes were evaluated. Results: There were no significant differences in the proportions of patients receiving treatment with antithrombotic drugs and NSAIDs between the groups that required and did not require surgery. In the surgery group, a larger number of patients had cerebral infarction at the same time as the colonic bleeding and received transfusion therapy. The indications for surgery were failure of endoscopic hemostasis, repeated bleeding, and severe bleeding. The median operation time was 103.5 minutes, the median blood loss was 30 mL, and complications（C-D, grade＞2）were observed in 10 cases（28％）. There was no mortality. The re-bleeding rate was 3％ in the surgery group. Conclusions: At present, the indications for surgery remain failure of endoscopic hemostasis, recurrent bleeding, and severe bleeding. We propose to consider the criteria of surgical indication.
