Management of colonic diverticular bleeding: A narrative review with literature search of current evidence and therapeutic strategies

Table 4 Key definitions used throughout this narrative review

Term	Definition
Definitive CDB	Colonic diverticular bleeding with endoscopic identification of stigmata of recent hemorrhage (SRH) at a diverticulum, or active bleeding observed during colonoscopy or angiography
Presumptive CDB	Suspected diverticular hemorrhage in a patient with diverticulosis identified at colonoscopy but without SRH or active bleeding at the diverticulum, after exclusion of other LGIB sources
Stigmata of recent hemorrhage (SRH)	Endoscopic findings indicative of recent bleeding, including active spurting/oozing bleeding, non-bleeding visible vessel, adherent clot, or flat pigmented spot at the diverticulum
Successful endoscopic hemostasis	Cessation of active bleeding and absence of recurrent bleeding during the index colonoscopy, with no clinical or laboratory evidence of ongoing hemorrhage
Early rebleeding	Recurrent hematochezia or hemodynamic instability within 30 days of initial hemostasis, requiring repeat intervention or hospitalization
Late rebleeding	Recurrent diverticular hemorrhage occurring beyond 30 days of the index episode, typically reported at 90 days, 365 days, or longer cumulative intervals
Technical success (TAE)	Successful catheterization of the bleeding vessel with deployment of embolic material and angiographic cessation of extravasation
Clinical success (TAE)	Absence of recurrent bleeding within 30 days following the procedure, with no requirement for additional intervention
Hemodynamic instability	Shock index (HR/SBP) > 1, persistent hypotension despite resuscitation, or ongoing transfusion requirement

CDB: Colonic diverticular bleeding; SRH: Stigmata of recent hemorrhage; TAE: Transcatheter arterial embolization; LGIB: Lower gastrointestinal bleeding; HR: Heart rate; SBP: Systolic blood pressure.