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Massive, life-threatening bleeding in Crohn's disease.

R Kostka1, M Lukás

  • 1Department of Surgery of Faculty Hospital Královské Vinohrady and 3rd Faculty of Medicine, Prague, Czech Rep. kosrod@seznam.cz

Acta Chirurgica Belgica
|May 24, 2005
PubMed
Summary

Acute lower gastrointestinal bleeding is a rare complication of Crohn's disease (CD). A conservative approach is recommended initially, but surgery is often necessary for severe or recurrent bleeding in CD patients.

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Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Surgical Gastroenterology

Background:

  • Acute lower gastrointestinal bleeding is an infrequent complication in Crohn's disease (CD).
  • Understanding the clinical course and management of this complication is crucial for patient outcomes.

Purpose of the Study:

  • To characterize the clinical features and outcomes of acute lower gastrointestinal bleeding in patients with Crohn's disease.
  • To evaluate the effectiveness of conservative and surgical management strategies.

Main Methods:

  • Retrospective analysis of six patients with Crohn's disease experiencing acute lower gastrointestinal bleeding between 1985 and 2003.
  • Data collection included patient demographics, bleeding episodes, diagnostic methods, and treatment outcomes.

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Main Results:

  • Six patients (3 male, 3 female; ages 17-42) experienced 11 severe hemorrhage episodes.
  • Four patients required emergency surgery, including three ileocolectomies and one ileectomy.
  • Three of four patients initially treated conservatively re-bled, necessitating surgery. Two non-resected patients achieved remission.

Conclusions:

  • A conservative approach can be the initial management strategy for acute lower GI bleeding in CD.
  • Surgical intervention is inevitable for patients with massive or recurrent bleeding episodes.
  • Surgical outcomes were favorable, with no recurrence of CD-related bleeding in most resected patients.