A case of Crohn's disease with recurrent massive life-threatening hemorrhage from terminal ileum

A case of Crohn's disease that underwent bowel resection two times at 3-yea r intervals due to life-threatening hemorrhage from ileum is presented. The bleeding sites were located in the ulcer lesions of ileum, in the oral sid e near to the ileum-colon transition. The first bleeding point was at the l ongitudinal ulcer of the terminal ileum and the secondary bleeding site was at the profound ulcer of ileum appearing in the oral side near to the ileo -colic anastomosis. This is the first case of Crohn's disease with recurren t life-threatening massive hemorrhage in the terminal region of ileum, for which operative bowel resections were necessary. This case suggests that we should search for the bleeding site in ileal lesions developed in the circ umference of and especially the oral side near to the anastomosis due to pr ior resection, when intestinal massive bleeding occurs again after bowel re section, and that the careful follow-up and strict treatment with diet ther apy and/or antiinflammatory drugs are necessary for the protection of recur rence in patients with Crohn's disease.