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Massive intestinal bleeding in association with Crohn's disease
C P Driver1, D N Anderson, R A Keenan
1Aberdeen Royal Hospitals NHS Trust, Foresterhill, UK.
Journal of the Royal College of Surgeons of Edinburgh
|June 1, 1996
Summary
Massive rectal bleeding is a rare but serious complication of Crohn's disease (CD). This study highlights challenges in identifying bleeding sites and significant patient morbidity and mortality associated with surgical treatment.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Crohn's disease (CD) is a chronic inflammatory bowel disease.
- Massive rectal bleeding is an uncommon but severe complication of CD.
Observation:
- A 20-year review identified 10 patients with significant rectal bleeding requiring transfusion.
- Pre-operative bleeding site identification was successful in only one patient.
- Colonic origin was confirmed in 90% of cases.
Findings:
- All 10 patients underwent surgery, with 7 requiring a stoma.
- Recurrent bleeding occurred in one patient.
- Early post-operative mortality was 20%.
Implications:
- Massive rectal bleeding in CD presents diagnostic and therapeutic challenges.
- Surgical intervention is often necessary but associated with high morbidity.
- Improved pre-operative localization strategies are needed for better patient outcomes.