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The bleeding recurrence rate after spontaneous hemostasis of colonic diverticular hemorrhage varies in the literature from 20% to 38%. These rates support the idea thatpreventive colonic resection might be necessary.Consecutive patients admitted for colonic diverticular bleeding from 1997 to 2005 wereprospectively studied. Data on age, gender, 30 day mortality, therapeutic modality for bleeding management, and subsequent re-bleeding were collected.One hundred and thirty-three patients of mean age 75.7 yearspresenting with 157 diverticular bleeding episodes were recruited. Bleeding stopped spontaneously in 123 patients (92.4%). Interventional approach was necessary in 10 patients (endoscopic treatment in 3, embolization in 4, and surgery in 5). Thirty day mortality for first bleeding was 3%. Out of the 120 patients who were managed conservatively and submitted to a mean follow-up of 39.5 months, 16 (13.3%)presented with recurrent diverticular bleeding. Spontaneous hemostasis could be obtained in all recurrent cases except one (6.25%) who died. The estimated bleeding recurrence rate was 4.1% at 1 year, 8.3% at 5 years and 12.5% at 10 years.The low estimated re-bleeding rate and the fact that re-bleeding could be treated conservatively in thisprospective series argue againstpreventive surgery.