A Case of Emergency Laparoscopic Surgery for Massive Hematochezia due to Diverticulitis

Abstract

Abstract We describe here the case of a 75-year-old woman who underwent emergency laparoscopic surgery for recurrent hemorrhages caused by diverticulosis of the right colon with subsequent anemia. At admission, physical examination revealed stable vital signs, and the abdomen was soft, non-tender, and non-distended. The hemoglobin level was 10.6 g/dL. No fresh blood clots were observed in the right colon lumen on colonoscopy. Ileocecal resection was planned; however, at 10 days after hospital admission, the patient presented with severe gastrointestinal bleeding; the hemoglobin level decreased to 7.2 g/dL, with the subsequent development of hemorrhagic shock. Blood transfusion (4 U of blood) was immediately performed; however, a second episode of massive hematochezia occurred after emergency angiography. Therefore, an emergency laparoscopic right colectomy was performed for resection of the diverticulosis of the right colon, followed by reconstruction with end-to-end anastomosis. The patient remained asymptomatic at 8 months of follow-up.