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Small bowel and Nutrition
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Recurrent brisk haematochezia in a patient with quiescent Crohn’s disease
  1. Zaira Gasanova1,
  2. Alexander Lemmer2,
  3. Emanuelle Bellaguarda2
  1. 1 Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  2. 2 Division of Gastroenterology & Hepatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Ms Zaira Gasanova, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA; zaira.gasanova{at}northwestern.edu

https://doi.org/10.1136/flgastro-2019-101404

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    Clinical presentation

    A 61-year-old man with severe Crohn’s disease presented with multiple admissions for recurrent episodes of large-volume haematochezia. He had a long history of stricturing Crohn’s disease requiring proctocolectomy with end ileostomy at age 24 and five subsequent small bowel resections. No evidence of active inflammation was visualised on an ileoscopy 2 months prior to initial presentation.

    The patient initially presented to the emergency department with maroon stool progressing to large-volume haematochezia from his ileostomy. There was no tenderness on abdominal exam. The patient urgently underwent an esophagogastroduodenoscopy and upper push enteroscopy followed by Technetium‐99 m red blood cell scintigraphy, all of which were negative. Subsequent ileoscopy showed an eroded anastomosis and proximal telangectasia, which were both successfully treated …

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    Footnotes

    • Contributors ZG performed data acquisition and wrote the manuscript. AL assisted in design, data acquisition and drafting. EB provided intellectual oversight and helped edit the manuscript. All authors reviewed and provided critical feedback on the final article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.