Clinical Analysis of Acute Severe Gastrointestinal Bleeding in Crohn's Disease / 胃肠病学

ABSTRACT

Background:Acute severe gastrointestinal bleeding is one of the severe complications of Crohn's disease (CD),and clinical data conceming its mechanism,characteristics and treatment are rare.Aims:To analyze the clinical characteristics and prognosis of acute severe gastrointestinal bleeding in CD.Methods:Clinical data of CD patients with acute severe gastrointestinal bleeding from January 2009 to April 2017 at Jinling Hospital were retrospectively analyzed,and the effect of various factors on rebleeding rate was analyzed.Results:Altogether 44 cases had acute severe gastrointestinal bleeding.Small intestine,ileocecum and anastomosis were the main bleeding sites,and 17 cases occurred with obscure bleeding site.History of enterectomy was found in 20 cases.Surgery was performed in 22 cases.Rebleeding occurred in 13 cases,including 11 cases within 1-year.No significant differences in rebleeding rate and 1-year rebleeding rate were found between patients received surgery and non-surgery treatment,patients with emergency surgery and selective surgery (P ＞0.05).Rebleeding rate was significantly lower in patients with bleeding site resected than in paitents with obscure bleeding stie (P ＜ 0.05),however,no significant difference in 1-year rebleeding rate was found betwwen the two groups (P =0.083).Conclusions:The incidence of acute severe gastrointestinal bleeding in CD is rather low,and the major bleeding sites are small intestine (among patients without enterectomy history) and anastomosis (among patients with enterectomy history).Surgery with bleeding site resected can decrease the recurrence of bleeding,which might be a protective factor for preventing rebleeding in CD patients.