Colonic diverticular hemorrhage

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Bright red PR bleeding, warfarinised for mechanic valve.

Patient Data

Age: 85 years
Gender: Female

The non contrast study shows some minor dense fecal debris within occasional colonic diverticuli. There is a backgorund of reasonbly severe colonic diverticulosis, most prominant in the descending and sigmoid colon.

The arterial and portal venous phases confirm a diverticular hemorrhage into the colonic lumen at the junction of the descending and sigmoid colon.

There is no evidence of acute diverticulitis.

Case Discussion

The bleeding settled with cessation of warfarin. The patient was discharged and followed up with an outpatient colonoscopy which confirmed extensive diverticulosis.

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