Life-threatening gastrointestinal hemorrhage is a rare complication in Crohn's disease. The authors experienced a case of Crohn's disease manifested with massive lower intestinal bleeding. A 22-year-old woman, who had underwent small bowel resection for bowel perforation and intestinal fistula, was admitted with lower abdominal pain and massive hernatochezia. A radioisotope bleeding scan and mesenteric angiography revealed suspi- cious intestinal bleeding in the small bowel area. The colonoscopy showed multiple shallow ulcers at the terminal ileum and scars on the cecum. In spite of medical management with the diagnosis of Crohn's disease, she continuecl to rebleed and required fistuloplasty and ileal resection. In the surgical specimen was discovered multiple exposed small vessels and diffuse blood oozing at terminal ileum. After surgery, there were no more bleeding episodes and she recovered with the aid treatment of sulfasalazine and prednisolone.
Abdominal Pain ; Angiography ; Blood Pressure* ; Cecum ; Cicatrix ; Colonoscopy ; Crohn Disease* ; Diagnosis ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Ileum ; Intestinal Fistula ; Prednisolone ; Sulfasalazine ; Ulcer ; Young Adult