Urgent Colonoscopy for the Diagnosis and Treatment of Severe Diverticular Hemorrhage

To the Editor: Jensen et al. (Jan. 13 issue) 1 report on 10 patients who had stigmata of diverticular hemorrhage and were treated endoscopically. None of the 10 had early or late episodes of recurrent bleeding (median follow-up period, 30 months). Unless diverticular hemorrhage is caused by inflammation or another reversible process, local treatment of a single diverticulum is unlikely to prevent bleeding from other diverticula (or even the index lesion). Diverticular hemorrhage appears to be caused by chronic injury of the vasa recta adjacent to the lumens of the diverticula, 2 which is unlikely to be reversible. In their study, Jensen . . .