Diverticulum Formation and Vasa Recta Erosion
Placeholder: weakened bowel wall herniates and exposes a penetrating artery.
- Right colon: Common site (Placeholder short note)
- Vasa recta: Vessel involved (Placeholder short note)
- ~50% by age 60: Prevalence (Placeholder short note)
- Wall thinning: Trigger (Placeholder short note)
Vessel erosion mechanism
Placeholder: chronic mechanical stress thins the vessel wall at the dome.
Painless Hematochezia as Presenting Symptom
Placeholder: painless, sudden, large-volume rectal bleeding is typical.
- Sudden: Onset (Placeholder short note)
- Usually absent: Pain (Placeholder short note)
- Maroon/red: Color (Placeholder short note)
- ~75-80%: Self-limited (Placeholder short note)
Clinical presentation
Placeholder: bleeding is often brisk but frequently stops spontaneously.
Colonoscopic Localization and Clip/Cautery Hemostasis
Placeholder: urgent colonoscopy locates the source and applies hemoclips.
- Clip / cautery: Method (Placeholder short note)
- High acute: Success rate (Placeholder short note)
- Within 24h: Timing (Placeholder short note)
- Rapid purge: Prep needed (Placeholder short note)
Endoscopic hemostasis technique
Placeholder: clips or thermal probes are applied directly to the bleeding vessel.
Angiographic Super-Selective Embolization
Placeholder: interventional radiology embolizes the feeding artery when endoscopy fails.
- Femoral artery: Access (Placeholder short note)
- Vasa recta: Target (Placeholder short note)
- Microcoils: Agent (Placeholder short note)
- Low, selective: Ischemia risk (Placeholder short note)
Embolization procedure
Placeholder: a microcatheter is advanced super-selectively before coil deployment.
Rebleeding Risk and Post-Procedure Monitoring
Placeholder: recurrence is tracked with labs, vitals, and scheduled follow-up.
- ~15-40%: Rebleed rate (Placeholder short note)
- Hgb trend: Monitoring (Placeholder short note)
- Colonoscopy: Follow-up (Placeholder short note)
- Fiber, risk mgmt: Prevention (Placeholder short note)
Monitoring and recurrence
Placeholder: serial hemoglobin and vitals guide discharge readiness.
Placeholder highlight: recurrent bleeding may prompt elective resection.