A 70-year-old man presents with severe haematochezia. Colonoscopy identifies diverticular bleeding in the sigmoid colon which has stopped spontaneously. He has had three similar episodes over 2 years. The most appropriate definitive management is:

• A Repeat colonoscopy with argon plasma coagulation at next episode
• B Elective sigmoid colectomy ✓
• C Long-term high-fibre diet and mesalazine
• D Angiographic embolisation as definitive therapy

Explanation

Recurrent diverticular haemorrhage (three or more episodes) is an established indication for elective sigmoid colectomy, which carries a low operative mortality in an elective setting and eliminates recurrent bleeding from that segment. Angiographic embolisation is a temporising measure for acute haemorrhage; it is not a definitive treatment, and rebleeding rates are substantial.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.