Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Dec 7, 2026; 32(45): 124008
Published online Dec 7, 2026. doi: 10.3748/wjg.124008
Published online Dec 7, 2026. doi: 10.3748/wjg.124008
Management of colonic diverticular bleeding: A narrative review with literature search of current evidence and therapeutic strategies
Abdelwahap Elghezewi, Department of Gastroenterology, Marshall University, Huntington, WV 25701, United States
Marwan Aljahani, Mustafa Ben Khayal, Department of Internal Medicine, Faculty of Medicine, University of Tripoli, Tripoli 00218, Libya
Author contributions: Elghezewi A contributed to conceptualization, writing original draft preparation, figure preparation, supervision and project administration; Elghezewi A, Ben Khayal M, Aljahani M contributed to methodology and search strategy design, literature screening and study selection, data extraction and synthesis writing review and editing; Elghezewi A, Ben Khayal M contributed to table preparation.
AI contribution statement: AI tools (specifically Claude, Anthropic) were used solely for linguistic refinement, formatting assistance, and reference organization during manuscript revision. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest to disclose. No financial or non-financial competing interests exist related to this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Abdelwahap Elghezewi, MD, Academic Fellow, Department of Gastroenterology, Marshall University, 249 15th St, Huntington, WV 25701, United States. elghezewia@marshall.edu
Received: June 4, 2026
Revised: June 28, 2026
Accepted: September 17, 2026
Published online: December 7, 2026
Processing time: 133 Days and 23.7 Hours
Revised: June 28, 2026
Accepted: September 17, 2026
Published online: December 7, 2026
Processing time: 133 Days and 23.7 Hours
Core Tip
Core Tip: Colonic diverticular bleeding (CDB) is the leading cause of acute lower gastrointestinal bleeding in Western populations, yet management remains inconsistently applied. This review synthesizes current evidence across the full CDB care pathway from risk stratification using the Oakland score to endoscopic, radiologic, and surgical decision-making. Endoscopic band ligation outperforms clipping for hemostasis, transcatheter arterial embolization achieves high technical success, and early antithrombotic resumption reduces mortality without excess rebleeding. A practical, evidence-based framework is provided to guide clinicians toward more standardized, outcome-driven care.