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An association between diabetes and complications in the colon has been reported, and even long-term use of metformin can cause colonic complications such as diverticulitis and ulceration[@B1]. Although most of the patients have not been diagnosed as having diabetes, they present with abdominal pain, nausea, vomiting and diarrhea. In a case report, colonic diverticulitis and bleeding due to polypoid growth in the submucosal layer were reported in a patient with diabetes[@B2]. In this case, a patient was initially diagnosed with type I diabetes mellitus and repeatedly suffered from abdominal pain and was later diagnosed with colonic diverticulosis. He subsequently developed severe bleeding and required an urgent operation. We report here on this rare case of colonic diverticulitis complicated with bleeding, with a review of the literature.


A 60-year-old male was referred to the emergency room due to profuse hematemesis and hematochezia. He had experienced pain and bloody diarrhea for 3 months, but had been diagnosed with type I diabetes mellitus 4 years ago. He was given oral metformin 1,000 mg once a day and exenatide once a day. On arrival, he was well-oriented but had mild tenderness on the right side of the abdomen. His blood pressure was 103/74 mm Hg, pulse rate was 77 beats/min, respiratory rate was 20/min, and body temperature was 36.6℃. On rectal examination, an elastic, hard mass was palpable on the right side of the rectum, and a large amount of hematemesis was present.

Blood chemistry showed hyperglycemia (glucose, 798 mg/dL). The hemoglobin level was 8.3 g/dL and hematocrit was 27.4%. White blood cell count was 17,400/µL, with 18.0% neutrophils, 52.8% lymphocytes, 1.8% monocytes, 17.8% eosinophils, and 1.4% basophils. Chest X-ray showed mild pleural effusion in

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