Vascular ectasias and diverticulosis. Common causes of lower intestinal bleeding.

Lower intestinal bleeding is an important medical problem frequently responsible for hospital admission in the United States. The two most common causes of this type of bleeding are colonic diverticula and vascular ectasias. Because ectasias are difficult to diagnose and because many older individuals have asymptomatic diverticula, it is often impossible to be certain that one of these lesions is the source of blood loss in a given patient. Fortunately, bleeding from an ectasia or a diverticulum usually stops spontaneously. A conservative approach to therapy, therefore, is strongly recommended. Should a careful evaluation fail to reveal the source of bleeding and treatment become necessary because of recurrent hemorrhage, the patient should undergo an elective right hemicolectomy. The extent of resection is not altered by the presence of diverticulosis in the left colon.