Repeated massive lower intestinal bleeding in Crohn's disease: Successful control by endoscopic therapy

Yuh Tsubouchi, Harukazu Kouyama, Teruaki Kawanishi, Hiroyuki Nishimori, Kenichirou Goto, Satoaki Mima, Hiderou Takasugi, Kiichi Imai, Yasushi Iwao, Toshifumi Hibi

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Abstract

In Crohn's disease, characterized by longitudinal ulcers and a cobblestone appearance of the intestinal mucosa, massive lower intestinal bleeding requiring blood transfusions to maintain normal vital signs is a relatively rare complication (1-3% of all cases). Although surgery may be the most appropriate treatment for such massive bleeding, recurrent hemorrhage is occasionally encountered. We describe a 23-year-old male patient with Crohn's disease who suffered massive bleeding three times within a two-year period, and successful hemostasis was obtained by endoscopic local injection of hypertonic saline epinephrine (HSE) and clipping on each occasion. It is rare for episodes of massive lower intestinal bleeding in Crohn's disease to be repeated over a relatively short period. In the present patient, emergency colonoscopy was diagnostically helpful, and the bleeding was successfully controlled by endoscopic therapy. Thus, endoscopic therapy should be used conservatively in Crohn's disease with recurrent major hemorrhage to avoid multiple abdominal surgery.

Original languageEnglish
Pages (from-to)2087-2094
Number of pages8
JournalGASTROENTEROLOGICAL ENDOSCOPY
Volume44
Issue number12
Publication statusPublished - 2002 Dec 1
Externally publishedYes

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Tsubouchi, Y., Kouyama, H., Kawanishi, T., Nishimori, H., Goto, K., Mima, S., Takasugi, H., Imai, K., Iwao, Y., & Hibi, T. (2002). Repeated massive lower intestinal bleeding in Crohn's disease: Successful control by endoscopic therapy. GASTROENTEROLOGICAL ENDOSCOPY, 44(12), 2087-2094.