Lower gastrointestinal bleeding due to diverticular disease in an elderly patient: case report and narrative review of the literature

Abstract

Introduction: Lower gastrointestinal bleeding (LGIB) is frequent in emergency departments. It requires systematic hemodynamic evaluation and endoscopic studies to identify the bleeding site and manage associated comorbidities. Objective: To describe the diagnostic and therapeutic process of an elderly patient with lower gastrointestinal bleeding, and to integrate a narrative review of the current evidence on the role of endoscopy and colonoscopy in the management of gastrointestinal bleeding. Methods: The clinical case of a 75-year-old female patient with LGIB was documented. Clinical, laboratory, and histopathological findings are described. A narrative review of the literature was conducted in the PubMed and Cochrane Library databases, including articles published between 2018 and 2026, prioritizing clinical trials, meta-analyses, and clinical practice guidelines on gastrointestinal bleeding and the role of endoscopic studies in its management. Results: The diagnosis of lower gastrointestinal bleeding secondary to uncomplicated diverticular disease was established. Delayed outpatient colonoscopy identified sigmoid diverticulosis (DICA I) and grade II internal hemorrhoids; upper endoscopy ruled out causes of upper gastrointestinal bleeding, and biopsies confirmed severe chronic gastritis associated with Helicobacter pylori. Conclusion: Hemodynamic control constitutes the cornerstone of the initial management of LGIB. Most episodes are self-limited without the need for invasive interventions. Early colonoscopy improves diagnostic yield and reduces hospital stay.

Recibido: 20/11/2025

Aprobado: 11/02/2026