Acute major gastrointestinal hemorrhage in inflammatory bowel disease

D. S. Pardi, Edward Vincent Loftus, Jr, W. J. Tremaine, W. J. Sandborn, G. L. Alexander, R. K. Balm, C. J. Gostout

Research output: Contribution to journalArticle

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Abstract

Background: Acute major gastrointestinal hemorrhage is uncommon in inflammatory bowel disease. Methods: We characterized the clinical features and course of such hemorrhage in patients at our institution from 1989 to 1996. Results: Thirty-one patients had acute lower gastrointestinal bleeding from inflammatory bowel disease and one had upper gastrointestinal bleeding from duodenal Crohn's disease. Three patients had ulcerative colitis and 28 had Crohn's disease, representing 0.1% of admissions for ulcerative colitis and 1.2% for Crohn's disease. In addition, another patient bled from an ileal J-pouch. In patients with Crohn's disease, the site of bleeding was duodenal in 1, small intestinal in 9, ileocolonic in 8, and colonic in 10. All ulcerative colitis patients had pancolitis. Medical therapy was initiated in 27 patients, including endoscopic therapy in 3. Five patients underwent surgery immediately, and 7 medically treated patients eventually required surgery for ongoing or recurrent bleeding. Conclusions: Acute major gastrointestinal bleeding is uncommon in inflammatory bowel disease. Most cases are due to Crohn's disease, without a predilection for site of involvement. The presence of an endoscopically treatable lesion is uncommon, and surgery is required in less than half of cases during the initial hospitalization. Recurrent hemorrhage is not rare, and for these cases surgery may be the most appropriate treatment.

Original languageEnglish (US)
Pages (from-to)153-157
Number of pages5
JournalGastrointestinal Endoscopy
Volume49
Issue number2
DOIs
StatePublished - 1999

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Gastrointestinal Hemorrhage
Inflammatory Bowel Diseases
Hemorrhage
Crohn Disease
Ulcerative Colitis
Colonic Pouches
Duodenal Diseases
Hospitalization
Therapeutics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Pardi, D. S., Loftus, Jr, E. V., Tremaine, W. J., Sandborn, W. J., Alexander, G. L., Balm, R. K., & Gostout, C. J. (1999). Acute major gastrointestinal hemorrhage in inflammatory bowel disease. Gastrointestinal Endoscopy, 49(2), 153-157. https://doi.org/10.1016/S0016-5107(99)70479-7

Acute major gastrointestinal hemorrhage in inflammatory bowel disease. / Pardi, D. S.; Loftus, Jr, Edward Vincent; Tremaine, W. J.; Sandborn, W. J.; Alexander, G. L.; Balm, R. K.; Gostout, C. J.

In: Gastrointestinal Endoscopy, Vol. 49, No. 2, 1999, p. 153-157.

Research output: Contribution to journalArticle

Pardi, DS, Loftus, Jr, EV, Tremaine, WJ, Sandborn, WJ, Alexander, GL, Balm, RK & Gostout, CJ 1999, 'Acute major gastrointestinal hemorrhage in inflammatory bowel disease', Gastrointestinal Endoscopy, vol. 49, no. 2, pp. 153-157. https://doi.org/10.1016/S0016-5107(99)70479-7
Pardi, D. S. ; Loftus, Jr, Edward Vincent ; Tremaine, W. J. ; Sandborn, W. J. ; Alexander, G. L. ; Balm, R. K. ; Gostout, C. J. / Acute major gastrointestinal hemorrhage in inflammatory bowel disease. In: Gastrointestinal Endoscopy. 1999 ; Vol. 49, No. 2. pp. 153-157.
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