A 70-year-old man with bloody stools was emergently transported to our hospital by ambulance. Abdominal/pelvic CT with contrast revealed blood extravasation in his transverse colon, and he was hospitalized due to suspected colonic diverticular bleeding. Lower gastrointestinal endoscopy revealed a diverticulum with erosion and redness in the transverse colon. The diverticulum was thought to be the responsible lesion, and endoscopic band ligation (EBL) was performed. After EBL, an exposed vessel was found in the inverted diverticulum. Endoscopic findings of active hemorrhage, non-hemorrhagic exposed vessels, or adherent blood clot are indications for hemostasis of colonic diverticular bleeding. Diverticular bleeding in which the inside of the responsible diverticulum cannot be observed by endoscopy, would be a good indication for EBL because it would be difficult to perform clip hemostasis through the direct approach.
