Two kinds of diverticular disease.

Two kinds of acquired diverticular disease were identified. The more common variety presented with pain, bowel symptoms or fistulae, and the less common with bleeding. The former patients rarely had a history of bleeding and among the latter pain and bowel symptoms were uncommon. In contrast to the few, chiefly sigmoid, diverticular often found in the former group, barium enemas of those presenting with bleeding usually showed densely packed and extensive diverticula. Even where there was no history suggesting perforation or evidence of it at operation, specimens resected for the more common form of diverticular disease invariably showed histological evidence of previous perforation. There was no histological evidence of previous perforation in those specimens resected for bleeding. This retrospective clinical, radiological and histological study supported the idea that there are two kinds of diverticular disease, one associated with perforation and its sequelae, the other associated with bleeding.