Massive intestinal bleeding in association with Crohn's disease.
Five hundred and one patients with Crohn's disease, presenting to a single surgical unit during a 20-year period, were reviewed by utilizing a computerized audit system. Ten patients were identified with rectal bleeding significant enough to require a blood transfusion to maintain cardiovascular homeostasis. The site of bleeding was correctly identified pre-operatively in only one patient, and at the time of surgery in only four patients. In nine (90%) of the 10 cases, the origin of the bleeding was subsequently found to be colonic. All 10 patients were treated surgically, with seven patients requiring fashioning of a stoma, none of whom had gastro-intestinal continuity subsequently re-established. Recurrent bleeding occurred in a single patient. The early post-operative mortality was 20%. Massive rectal bleeding remains an uncommon complication of Crohn's disease, and still carries significant morbidity and mortality. Pre-operative localization of the site of bleeding is uncommon, making intra-operative identification of the bleeding area difficult.
Driver
C P
CP
Aberdeen Royal Hospitals NHS Trust, Foresterhill, UK.
Anderson
D N
DN
Keenan
R A
RA
D000328:Adult; D001803:Blood Transfusion; D003082:Colectomy; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D012606:Scotland / Q000453:epidemiology