Massive Lower Gastrointestinal Bleed caused by Typhoid Ulcer: Conservative Management

Area of Science:

• Gastroenterology
• Infectious Diseases
• Internal Medicine

Background:

• Typhoid fever, a systemic infection caused by Salmonella typhi, classically presents with high fever.
• Gastrointestinal (GI) complications such as hemorrhage and perforation, though less common with antibiotic use, remain significant risks.
• Ulceration in the terminal ileum is a known, albeit infrequent, cause of GI bleeding in typhoid fever cases.

Purpose of the Study:

• To report a rare case of massive lower gastrointestinal bleeding secondary to typhoid fever.
• To illustrate the successful conservative management of a patient with typhoid-induced GI hemorrhage.
• To emphasize that surgical or endoscopic intervention may not always be necessary for such complications.

Main Methods:

• A case report of a young female patient diagnosed with typhoid fever.
• Clinical presentation included massive lower GI bleeding attributed to typhoid ulcers in the terminal ileum.
• Management focused on conservative measures, avoiding endotherapy and surgical intervention.

Main Results:

• The patient experienced a massive lower GI bleed originating from typhoid ulcers.
• Conservative management strategies were successfully employed.
• The patient recovered without the need for invasive procedures like endoscopy or surgery.

Conclusions:

• Massive lower GI bleeding can be a severe complication of typhoid fever, even in the antibiotic era.
• Conservative management can be a viable and effective approach for typhoid-induced GI hemorrhage.
• This case underscores the importance of considering typhoid fever in the differential diagnosis of GI bleeding, particularly in endemic areas.