The significance of diverticula of the colon in massive melena.

Abstract

Massive melena without hematemesis is often a challenging diagnostic problem. Diverticula of the colon demonstrated in such cases are often overlooked as the source of bleeding. Furthermore, both the clinician and the pathologist have been reluctant to accept diverticula as the source of hemorrhage because a bleeding point may be difficult to demonstrate, even at autopsy. To evaluate the frequency and magnitude of hemorrhage from these lesions, 317 unselected patients with diverticula of the colon were surveyed. The incidence of diverticulosis of the colon has been estimated at 5 to 10% of all the population over 40 years of age. This has been substantiated by Sauer 1 who found them in 5.2% of 70,572 subjects examined, and by Pemberton, Black, and Maino 2 who found them in 8.5%. Rankin and Brown 3 have stated that 15 to 20% of all those with diverticulosis will develop diverticulitis. Therefore, it seems logical