Hui YQ, Wang ZX, Wang CX, Tong C. Colonic diverticular hemorrhage: Etiology, diagnostic challenges, and evolving therapeutic strategies. World J Gastroenterol 2026; 32(4): 114842 [DOI: 10.3748/wjg.v32.i4.114842]
Corresponding Author of This Article
Chun-Xi Wang, Professor, Department of Urology, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. wangchunxi_2020@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yi-Qing Hui, Chuan Tong, School of Nursing, Jilin Medical University, Jilin 132000, Jilin Province, China
Zhi-Xuan Wang, Chun-Xi Wang, Department of Gastric and Intestinal, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Chun-Xi Wang, Department of Urology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Co-corresponding authors: Chun-Xi Wang and Chuan Tong.
Author contributions: Hui YQ conducted the comprehensive literature search, organized relevant references, and drafted the initial version of the manuscript; Wang ZX contributed to the critical analysis of gastrointestinal surgical literature and assisted in refining the clinical perspectives; Wang CX conceptualized the review, supervised the overall work, and provided critical revisions for important intellectual content; Tong C participated in data organization, figure preparation, and assisted in manuscript editing; Wang CX and Tong C made equal contributions as co-corresponding authors. All authors contributed to the intellectual development of the review, read, and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Xi Wang, Professor, Department of Urology, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. wangchunxi_2020@126.com
Received: September 29, 2025 Revised: November 1, 2025 Accepted: November 28, 2025 Published online: January 28, 2026 Processing time: 115 Days and 6 Hours
Abstract
Colonic diverticular hemorrhage is a major cause of acute lower gastrointestinal bleeding, particularly in aging populations with increasing prevalence of diverticulosis. Its pathogenesis is multifactorial, involving vascular fragility of the vasa recta, mechanical stress, and patient-related factors such as comorbidities and use of antithrombotic agents. Diagnosis remains challenging due to the intermittent nature of bleeding, with colonoscopy serving as the primary tool and computed tomography angiography providing complementary value for source localization. Endoscopic therapy, especially band ligation, has demonstrated superiority over clipping in reducing rebleeding, while transcatheter arterial embolization has emerged as an effective salvage approach when endoscopic treatment fails. Surgical intervention is reserved for refractory or complicated cases. Recent advances include risk stratification models to guide management and early feeding strategies to accelerate recovery. Despite these improvements, challenges remain in recurrence prevention and individualized treatment selection. This editorial synthesizes current evidence on the etiology, diagnostic modalities, and evolving therapeutic strategies of colonic diverticular hemorrhage, aiming to support clinical decision-making and optimize patient outcomes.
Core Tip: Colonic diverticular hemorrhage is a leading cause of acute lower gastrointestinal bleeding, especially prevalent in aging populations with diverticulosis. Its pathogenesis involves multiple factors, diagnosis relies on colonoscopy and computed tomography angiography, and therapeutic advances including endoscopic band ligation, transcatheter embolization, and minimally invasive surgery have improved outcomes. This editorial summarizes key evidence to guide individualized management and recurrence prevention.
