Diverticular bleeding

Jeff T Wilkins, Christine Baird, Andrew N. Pearson, Robert R. Schade

Research output: Contribution to journalReview article

16 Citations (Scopus)

Abstract

Diverticular bleeding is a common cause of lower gastrointestinal hemorrhage. Patients typically present with massive and painless rectal hemorrhage. If bleeding is severe, initial resuscitative measures should include airway maintenance and oxygen supplementation, followed by measurement of hemoglobin and hematocrit levels, and blood typing and crossmatching. Patients may need intravenous fluid resuscitation with normal saline or lactated Ringer's solution, followed by transfusion of packed red blood cells in the event of ongoing bleeding. Diverticular hemorrhage resolves spontaneously in approximately 80 percent of patients. If there is severe bleeding or significant comorbidities, patients should be admitted to the intensive care unit. The recommended initial diagnostic test is colonoscopy, performed within 12 to 48 hours of presentation and after a rapid bowel preparation with polyethylene glycol solutions. If the bleeding source is identified by colonoscopy, endoscopic therapeutic maneuvers can be performed. These may include injection with epinephrine or electrocautery therapy. If the bleeding source is not identified, radionuclide imaging (i.e., technetium-99m-tagged red blood cell scan) should be performed, usually followed by arteriography. For ongoing diverticular hemorrhage, other therapeutic modalities such as selective embolization, intra-arterial vasopressin infusion, or surgery, should be considered.

Original languageEnglish (US)
Pages (from-to)977-983
Number of pages7
JournalAmerican Family Physician
Volume80
Issue number9
StatePublished - Nov 1 2009

Fingerprint

Hemorrhage
Blood Grouping and Crossmatching
Colonoscopy
Intra Arterial Infusions
Erythrocyte Transfusion
Electrocoagulation
Gastrointestinal Hemorrhage
Technetium
Vasopressins
Hematocrit
Routine Diagnostic Tests
Resuscitation
Radionuclide Imaging
Epinephrine
Intensive Care Units
Comorbidity
Angiography
Hemoglobins
Therapeutics
Erythrocytes

ASJC Scopus subject areas

  • Family Practice

Cite this

Wilkins, J. T., Baird, C., Pearson, A. N., & Schade, R. R. (2009). Diverticular bleeding. American Family Physician, 80(9), 977-983.

Diverticular bleeding. / Wilkins, Jeff T; Baird, Christine; Pearson, Andrew N.; Schade, Robert R.

In: American Family Physician, Vol. 80, No. 9, 01.11.2009, p. 977-983.

Research output: Contribution to journalReview article

Wilkins, JT, Baird, C, Pearson, AN & Schade, RR 2009, 'Diverticular bleeding', American Family Physician, vol. 80, no. 9, pp. 977-983.
Wilkins JT, Baird C, Pearson AN, Schade RR. Diverticular bleeding. American Family Physician. 2009 Nov 1;80(9):977-983.
Wilkins, Jeff T ; Baird, Christine ; Pearson, Andrew N. ; Schade, Robert R. / Diverticular bleeding. In: American Family Physician. 2009 ; Vol. 80, No. 9. pp. 977-983.
@article{1b8b3def2909483e9927aa48569b20fa,
title = "Diverticular bleeding",
abstract = "Diverticular bleeding is a common cause of lower gastrointestinal hemorrhage. Patients typically present with massive and painless rectal hemorrhage. If bleeding is severe, initial resuscitative measures should include airway maintenance and oxygen supplementation, followed by measurement of hemoglobin and hematocrit levels, and blood typing and crossmatching. Patients may need intravenous fluid resuscitation with normal saline or lactated Ringer's solution, followed by transfusion of packed red blood cells in the event of ongoing bleeding. Diverticular hemorrhage resolves spontaneously in approximately 80 percent of patients. If there is severe bleeding or significant comorbidities, patients should be admitted to the intensive care unit. The recommended initial diagnostic test is colonoscopy, performed within 12 to 48 hours of presentation and after a rapid bowel preparation with polyethylene glycol solutions. If the bleeding source is identified by colonoscopy, endoscopic therapeutic maneuvers can be performed. These may include injection with epinephrine or electrocautery therapy. If the bleeding source is not identified, radionuclide imaging (i.e., technetium-99m-tagged red blood cell scan) should be performed, usually followed by arteriography. For ongoing diverticular hemorrhage, other therapeutic modalities such as selective embolization, intra-arterial vasopressin infusion, or surgery, should be considered.",
author = "Wilkins, {Jeff T} and Christine Baird and Pearson, {Andrew N.} and Schade, {Robert R.}",
year = "2009",
month = "11",
day = "1",
language = "English (US)",
volume = "80",
pages = "977--983",
journal = "American Family Physician",
issn = "0002-838X",
publisher = "American Academy of Family Physicians",
number = "9",

}

TY - JOUR

T1 - Diverticular bleeding

AU - Wilkins, Jeff T

AU - Baird, Christine

AU - Pearson, Andrew N.

AU - Schade, Robert R.

PY - 2009/11/1

Y1 - 2009/11/1

N2 - Diverticular bleeding is a common cause of lower gastrointestinal hemorrhage. Patients typically present with massive and painless rectal hemorrhage. If bleeding is severe, initial resuscitative measures should include airway maintenance and oxygen supplementation, followed by measurement of hemoglobin and hematocrit levels, and blood typing and crossmatching. Patients may need intravenous fluid resuscitation with normal saline or lactated Ringer's solution, followed by transfusion of packed red blood cells in the event of ongoing bleeding. Diverticular hemorrhage resolves spontaneously in approximately 80 percent of patients. If there is severe bleeding or significant comorbidities, patients should be admitted to the intensive care unit. The recommended initial diagnostic test is colonoscopy, performed within 12 to 48 hours of presentation and after a rapid bowel preparation with polyethylene glycol solutions. If the bleeding source is identified by colonoscopy, endoscopic therapeutic maneuvers can be performed. These may include injection with epinephrine or electrocautery therapy. If the bleeding source is not identified, radionuclide imaging (i.e., technetium-99m-tagged red blood cell scan) should be performed, usually followed by arteriography. For ongoing diverticular hemorrhage, other therapeutic modalities such as selective embolization, intra-arterial vasopressin infusion, or surgery, should be considered.

AB - Diverticular bleeding is a common cause of lower gastrointestinal hemorrhage. Patients typically present with massive and painless rectal hemorrhage. If bleeding is severe, initial resuscitative measures should include airway maintenance and oxygen supplementation, followed by measurement of hemoglobin and hematocrit levels, and blood typing and crossmatching. Patients may need intravenous fluid resuscitation with normal saline or lactated Ringer's solution, followed by transfusion of packed red blood cells in the event of ongoing bleeding. Diverticular hemorrhage resolves spontaneously in approximately 80 percent of patients. If there is severe bleeding or significant comorbidities, patients should be admitted to the intensive care unit. The recommended initial diagnostic test is colonoscopy, performed within 12 to 48 hours of presentation and after a rapid bowel preparation with polyethylene glycol solutions. If the bleeding source is identified by colonoscopy, endoscopic therapeutic maneuvers can be performed. These may include injection with epinephrine or electrocautery therapy. If the bleeding source is not identified, radionuclide imaging (i.e., technetium-99m-tagged red blood cell scan) should be performed, usually followed by arteriography. For ongoing diverticular hemorrhage, other therapeutic modalities such as selective embolization, intra-arterial vasopressin infusion, or surgery, should be considered.

UR - http://www.scopus.com/inward/record.url?scp=71649090849&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=71649090849&partnerID=8YFLogxK

M3 - Review article

C2 - 19873964

AN - SCOPUS:71649090849

VL - 80

SP - 977

EP - 983

JO - American Family Physician

JF - American Family Physician

SN - 0002-838X

IS - 9

ER -