title: Ileocecal resection for massive rectal bleeding due to Yersinia enterocolitica: a case report and review of the literature.
abstract: BACKGROUND
  Massive gastrointestinal bleeding is an emergency that can sometimes require immediate surgery. We report the first case, to the best of our knowledge, of massive rectal bleeding due to Yersinia enterocolitica, requiring ileocecal resection.
  
  
  METHODS
  A 41-year-old North African woman was admitted to our emergency department for massive rectal bleeding. She had a history of an iron deficiency anemia of unknown cause, and diarrhea 2 months before the admission. On admission to our emergency unit, she was in a state of hemodynamic collapse. An examination showed discolored conjunctivas, massive rectal bleeding with clots and no abdominal pain. The first medical treatment included the use of noradrenaline. An upper gastrointestinal endoscopy was performed and did not show any lesions. Computed tomography of her abdomen showed significant and hypervascular wall thickening of her terminal ileum suggestive of a tumor. Because her massive rectal bleeding worsened and her collapse persisted, an exploratory laparotomy and ileocecal resection were immediately performed on the patient. Histopathological analysis showed enteritis caused by Yersinia enterocolitica. Her outcome was favorable.
  
  
  CONCLUSIONS
  Enteritis due to Yersinia enterocolitica can take a pseudotumoral form and mislead the diagnosis of gastrointestinal bleeding.
authors.affiliation: EFD-Hepatogastroenterology, Ibn Sina Hospital, Rabat, Morocco. ilham.azghari@yahoo.fr.
authors.forename: Ilham
authors.initials: I
authors.lastname: Azghari
authors.affiliation: EFD-Hepatogastroenterology, Ibn Sina Hospital, Rabat, Morocco. aichabargacha@gmail.com.
authors.forename: Aicha
authors.initials: A
authors.lastname: Bargach
authors.affiliation: Radiology Unit, Ibn Sina Hospital, Rabat, Morocco. moatassimbillah.nabil@gmail.com.
authors.forename: Nabil Moatassim
authors.initials: NM
authors.lastname: Billah
authors.affiliation: Anatomopathology Unit, Ibn Sina Hospital, Rabat, Morocco. essaoudimedamine@gmail.com.
authors.forename: Mohamed Amine
authors.initials: MA
authors.lastname: Essaoudi
authors.affiliation: Anatomopathology Unit, Ibn Sina Hospital, Rabat, Morocco. jahid_golden@hotmail.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Jahid
authors.affiliation: EFD-Hepatogastroenterology, Ibn Sina Hospital, Rabat, Morocco. nawalkabbaj@yahoo.fr.
authors.forename: Nawal
authors.initials: N
authors.lastname: Kabbaj
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002432:Cecum / Q000601:surgery*; D003967:Diarrhea / Q000382:microbiology; D004632:Emergency Medical Services; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007501:Iron / Q000627:therapeutic use; D007813:Laparotomy; D014057:Tomography, X-Ray Computed; D014131:Trace Elements / Q000627:therapeutic use; D016896:Treatment Outcome; D015009:Yersinia Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D015008:Yersinia enterocolitica / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D014131:Trace Elements; D007501:Iron