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Microangiographic findings of massive intestinal bleeding in a patient with Crohn's disease: a case report
Insights
This study details a case of Crohn's disease in a young man presenting with severe gastrointestinal symptoms. Angiography and microangiography identified bleeding in the ileum, specifically from the submucosal arteriae rectae.
Area of Science:
- Gastroenterology
- Vascular Medicine
- Surgical Pathology
Background:
- Crohn's disease is a chronic inflammatory bowel disease.
- Gastrointestinal bleeding and obstruction are known complications.
- Identifying the precise source of bleeding is crucial for management.
Observation:
- A 16-year-old male presented with classic Crohn's disease symptoms including abdominal pain, diarrhea, fever, and weight loss.
- The patient developed significant complications, including intestinal obstruction and massive intestinal bleeding.
- Selective angiography of the superior mesenteric artery was performed to localize the bleeding.
Findings:
- Angiography successfully identified the bleeding site within the ileum.
- Microangiography of surgical specimens revealed characteristic findings.
- Abrupt interruptions of the arteriae rectae in the submucosa were observed, confirming the source of bleeding within the diseased intestinal wall.
Implications:
- This case underscores the utility of advanced imaging techniques like angiography and microangiography in diagnosing obscure gastrointestinal bleeding.
- Understanding the specific vascular pathology in Crohn's disease can guide treatment strategies.
- Accurate localization of bleeding is crucial for effective surgical or interventional management in severe Crohn's disease cases.
Abstract:
A 16 year old man with complaints of abdominal pain, diarrhea, high fever and loss of body weight was made a diagnosis of Crohn's disease. During the administration, he had intestinal obstruction and several episodes of massive intestinal bleeding. Selective angiography of the superior mesenteric artery demonstrated the bleeding site in the ileum. Microangiography of the surgical specimens revealed abrupt interruptions of arteriae rectae in the submucosa indicating the bleeding site from the diseased intestine.