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Massive rectal bleeding due to ileal tuberculosis.

T Watanabe¹, M Kudo, M Kayaba

¹Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, Japan.

Journal of Gastroenterology

|August 19, 1999

Summary

Massive rectal bleeding can rarely signal ileal tuberculosis. Diagnosis involved scintigraphy and surgery, revealing ulcers and granulomas in the small intestine.

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Area of Science:

Gastroenterology
Infectious Diseases
Surgical Pathology

Background:

Intestinal tuberculosis is an uncommon cause of gastrointestinal bleeding.
Rectal bleeding is a rare presenting symptom of intestinal tuberculosis, particularly when originating from the ileum.

Observation:

A patient presented with massive rectal bleeding.
Technetium-99m labelled red blood cell scintigraphy localized the hemorrhage to the ileum.
Laparotomy revealed a 70-cm segment of ileum with ulcers and erosions.

Findings:

Histopathological examination of the resected ileal segment showed epithelioid granulomas with Langhans-type giant cells, confirming ileal tuberculosis.
The findings highlight a rare presentation of intestinal tuberculosis.

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Implications:

This case underscores the importance of considering intestinal tuberculosis in the differential diagnosis of unexplained massive rectal bleeding.
Early recognition and appropriate management are crucial for patients with intestinal tuberculosis presenting with severe gastrointestinal hemorrhage.