Diverticular bleeding is the most common source of lower GI bleeds and accounts for 17 to 40 percent of cases
The most common presentation (80%) is massive painless rectal bleeding.
Patients may have some cramping prior to a bloody bowel movement but otherwise will typically have no abdominal pain.
The majority of the cases will resolve spontaneously, but those requiring more than 4 units of Packed Red Blood Cells should be considered for an angiogram or surgery.
Angiography can be used to localize the site of bleeding and embolize the bleeding source.
If embolization fails the patient may require a partial colectomy to treat the bleeding source.