title: Successful endoscopic hemoclipping of massive lower gastrointestinal bleeding from paratyphoid A fever.
abstract: Paratyphoid fever can be complicated by massive lower gastrointestinal bleeding with ileocolonic ulcerations, which are commonly localized using colonoscopy. The most common manifestations include multiple, variable-sized, round or oval-shaped, punched-out ulcers. Occasionally, massive lower gastrointestinal bleeding can occur from erosion of blood vessels. We present a rare case of severe lower gastrointestinal bleeding due to paratyphoid A fever that was successfully controlled with hemoclippings. A 30-year-old man experienced high fever and hematochezia whose blood culture showed Salmonella paratyphi A. A complete colonoscopy was successfully performed up to the level of the terminal ileum, which showed multiple, shallow, ulcerated lesions over the entire terminal ileum. A bleeding vessel was seen in one of the ulcers, with overlaying blood clots. Endoscopic hemostasis was successfully performed with four pieces of endoclip and without immediate complication. This report highlights the use of colonoscopy and endoscopic therapy with endoclips for lower gastrointestinal bleeding, which should be considered before surgery.
authors.affiliation: Hui Wang, Xiao-Lin Dong, Xiao-Ming Yu, Kyu Sung Chung, Jian-Peng Gao, Department of Gastroenterology, The Affiliated YanAn Hospital of Kunming Medical University, Kunming 650051, Yunnan Province, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Hui Wang, Xiao-Lin Dong, Xiao-Ming Yu, Kyu Sung Chung, Jian-Peng Gao, Department of Gastroenterology, The Affiliated YanAn Hospital of Kunming Medical University, Kunming 650051, Yunnan Province, China.
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Dong
authors.affiliation: Hui Wang, Xiao-Lin Dong, Xiao-Ming Yu, Kyu Sung Chung, Jian-Peng Gao, Department of Gastroenterology, The Affiliated YanAn Hospital of Kunming Medical University, Kunming 650051, Yunnan Province, China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Yu
authors.affiliation: Hui Wang, Xiao-Lin Dong, Xiao-Ming Yu, Kyu Sung Chung, Jian-Peng Gao, Department of Gastroenterology, The Affiliated YanAn Hospital of Kunming Medical University, Kunming 650051, Yunnan Province, China.
authors.forename: Kyu Sung
authors.initials: KS
authors.lastname: Chung
authors.affiliation: Hui Wang, Xiao-Lin Dong, Xiao-Ming Yu, Kyu Sung Chung, Jian-Peng Gao, Department of Gastroenterology, The Affiliated YanAn Hospital of Kunming Medical University, Kunming 650051, Yunnan Province, China.
authors.forename: Jian-Peng
authors.initials: JP
authors.lastname: Gao
mesh_terms: D000328:Adult; D003108:Colonic Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D003113:Colonoscopy; D005334:Fever / Q000382:microbiology; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D008297:Male; D010284:Paratyphoid Fever / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D012482:Salmonella paratyphi A / Q000472:pathogenicity*; D012720:Severity of Illness Index; D013525:Surgical Instruments; D016896:Treatment Outcome; D014456:Ulcer / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*
keywords: Endoscopic hemoclipping hemostasis; Lower gastrointestinal bleeding; Paratyphoid A fever