A Case of Massive Gastrointestinal Bleeding Due to Abdominal Tuberculosis

This case is about a complication of abdominal tuberculosis in the form of a massive lower gastrointestinal (GI) bleed, which was timely intervened by angioembolization. A young man in his mid-20s on empirical anti-tubercular therapy (ATT) for abdominal tuberculosis, presented with severe abdominal...

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Bibliographic Details
Published in:Middle East journal of digestive diseases 2023, Vol.15 (3), p.207-209
Main Authors: Bana, Sai Krishna Reddy, Lakshmanan, Suja, Rajendran, Vaasanthi, N, Senthil, Anil, Archa Anna, L, Nanthakumar
Format: Report
Language:English
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Summary:This case is about a complication of abdominal tuberculosis in the form of a massive lower gastrointestinal (GI) bleed, which was timely intervened by angioembolization. A young man in his mid-20s on empirical anti-tubercular therapy (ATT) for abdominal tuberculosis, presented with severe abdominal pain. The patient then developed frank per rectal bleeding, leading to a significant drop in hemoglobin level, requiring multiple blood transfusions. Upper GI endoscopy and colonoscopy findings were inconclusive. Contrast-enhanced computed tomography (CECT) of the abdomen was performed, which revealed a contrast extravasation into the jejunum due to a leak in the jejunal branch of the superior mesenteric artery (SMA), followed by selective SMA angiography (digital subtraction angiography), which was arrested by angioembolization. The patient had multiple abdominal lymphadenopathies with omental nodules. Histopathological examination of the omental nodules revealed epithelioid granuloma with Langerhans-type cells. The patient is currently receiving ATT and is doing well.
ISSN:2008-5230
DOI:10.34172/mejdd.2023.346