To investigate the strategy in the diagnosis and treatment of Crohn’s disease that represents lower gastrointestinal tract massive hemorrhage as the first symptom.A case of Crohn’s disease was retrospectively analyzed, combined with pertinent literature review.Blood transfusion, supportive therapy, and operation were administered to establish the final diagnosis of Crohn’s disease.The case analysis indicated that operation is valuable for treating Crohn’s disease in case that lower gastrointestinal tract massive hemorrhage is the first symptom and intestinal symptoms are atypical or absent.In order to prevent postoperative hemorrhage, biological agent is the first choice.
ZHANG Dongwei
,
YANG Changqing
. A case of Crohn’s disease initially presenting with massive hematochezia[J]. Surgical Research and New Technique, 2018
, 7(3)
: 211
-213
.
DOI: 10.3969/j.issn.2095-378X.2018.03.016
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