Article (Scientific journals)
Acute Lower Gastrointestinal Bleeding in Crohn's Disease: Characteristics of a Unique Series of 34 Patients. Belgian Ibd Research Group
Belaiche, Jacques; Louis, Edouard; D'Haens, Geert et al.
1999In American Journal of Gastroenterology, 94 (8), p. 2177-81
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Abstract :
[en] OBJECTIVE: Acute lower gastrointestinal bleeding is a rare complication of Crohn's disease, which represents a diagnostic and therapeutic challenge. The aim of this study was to define epidemiological characteristics and therapeutic options of hemorrhagic forms of Crohn's disease. METHODS: Thirty-four cases of hemorrhagic forms of Crohn's disease were studied retrospectively. Acute lower gastrointestinal hemorrhage was defined as acute rectal bleeding originating in diseased bowel and requiring a transfusion of at least 2 units of red blood cells within 24 h. Upper gastrointestinal tract hemorrhage or anal lesions and postoperative bleeding were excluded. RESULTS: Mean age at time of hemorrhage was 34.2 +/- 14 yr. Mean duration of disease before the hemorrhage was 5.6 +/- 6 yr. The hemorrhage occurred during a flare up of the disease in 35% of cases. The hemorrhage revealed Crohn's disease in 23.5% of cases. The hemorrhage was more frequent in colonic disease (85%) than in isolated small bowel disease (15%) (p < 0.0001). The origin of bleeding was identified in 65% of cases, by colonoscopy (60%), by angiography (3 patients), or at surgery (1 patient). The bleeding lesion was an ulcer in 95% of cases, most often in the left colon. The treatment was surgical in 20.5% (colectomy in 36%), endoscopical (7 patients, including 5 successes), or medical. Hemorrhage recurred in 12 patients (35%) within a mean time of 3 yr (4 days-8 yr), requiring surgery in 3 cases. No death was observed. CONCLUSIONS: This study performed in a series characterized by a nonsurgical recruitment, the largest to date, shows that hemorrhagic forms of Crohn's disease may reveal disease in 23.5%, occurs in quiescent Crohn's disease in two-thirds of cases. Given the potential efficacy of endoscopical or medical treatment, as well as the absence of mortality, a conservative approach may be suggested as first-line therapy in the majority of patients.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Belaiche, Jacques ;  Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Louis, Edouard  ;  Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
D'Haens, Geert
Cabooter, Marc
Naegels, Serge
De Vos, Martine
Fontaine, Fernand
Schurmans, Piet
Baert, Filip
De Reuck, Mark
Fiasse, René
Holvoet, Jan
Schmit, Alain
Van Outryve, Marc
More authors (4 more) Less
Language :
English
Title :
Acute Lower Gastrointestinal Bleeding in Crohn's Disease: Characteristics of a Unique Series of 34 Patients. Belgian Ibd Research Group
Publication date :
August 1999
Journal title :
American Journal of Gastroenterology
ISSN :
0002-9270
eISSN :
1572-0241
Publisher :
Wolters Kluwer Health, Philadelphia, United States - Pennsylvania
Volume :
94
Issue :
8
Pages :
2177-81
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 26 November 2009

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