An upright CXR and acute abdominal series may reveal free intraperitoneal air. Treatment also includes insertion of an NG tube, Foley catheter, and administration of IV antibiotics. Surgical exploration should follow immediately. Surgical treatment involves resection of the involved colon, abdominal irrigation, drainage of any abscess and formation of a colostomy. The average age is 65 years.
Diverticular hemorrhage is usually massive but self-limited.
Bleeding stops spontaneously with supportive management in 70 - 95 percent of cases. Recurrent episodes occur in 25 percent of patients. Classic bleeding in diverticulosis is painless and associated with the sudden passage of a large amount of bright red or maroon-colored stool. Orthostatic symptoms may ensue. Mild cramping abdominal pain is due to the cathartic effect of the intracolonic blood.