Massive rectal bleeding due to ileal tuberculosis

Abstract

A patient with massive rectal bleeding due to ileal tuberculosis is reported. Technetium-99m labelled red blood cell scintigraphy indicated hemorrhage from the ileum, and laparotomy was then carried out. A 70-cm segment of ileum containing ulcers and erosions was resected, and epitheloid granuloma with Langhans-type giant cell was found in the resected specimen. Massive rectal bleeding is considered a rare presenting symptom of intestinal tuberculosis. Intestinal tuberculosis, including small intestinal tuberculosis, although uncommon, should be taken into consideration as a cause of rectal bleeding.

A Case of Gastric Tuberculosis Mimicking Advanced Gastric Cancer

“…It has also been suggested that, although intestinal tuberculosis results in increased capillary vascularity, small arteries undergo obliterative endarteritis in tuberculosis. This would explain the rarity of bleeding in such cases12).…”

Ileal tuberculosis presenting as a case of massive rectal bleeding

“…Intestinal tuberculosis presenting with lower gastrointestinal bleed is rare and accounts for about 5% of cases of lower gastrointestinal bleeding 2,3. In the presence of active pulmonary tuberculosis, vague abdominal pain, weight loss, and passage of a small amount of blood from the rectum could suggest the possibility of intestinal tuberculosis 2,6…”

“…Most patients present with low grade fever, weight loss, abdominal pain, anorexia, or diarrhea 1. Ileal tuberculosis is one of the commonly encountered surgical emergencies; the incidence of intestinal tuberculosis in presence of active pulmonary tuberculosis is between 3%–90% 2,3. Varied acute presentations of ileal tuberculosis are encountered such as subacute intestinal obstruction due to stricture or adhesions, or tuberculous stricture perforation.…”

Endoscopic Management of Acute Lower Gastrointestinal Bleeding

“…Previous reports indicate that surgery remains the definitive management for the treatment of patients with massive gastrointestinal bleeding due to intestinal TB [78,79] . Indeed, timely resection dramatically improved the condition of patients.…”