A 61-year-old man with severe Crohn’s disease presented with multiple admissions for recurrent episodes of large-volume haematochezia. He had a long history of stricturing Crohn’s disease requiring proctocolectomy with end ileostomy at age 24 and five subsequent small bowel resections. No evidence of active inflammation was visualised on an ileoscopy 2 months prior to initial presentation. The patient initially presented to the emergency department with maroon stool progressing to large-volume haematochezia from his ileostomy. There was no tenderness on abdominal exam. The patient urgently underwent an esophagogastroduodenoscopy and upper push enteroscopy followed by Technetium‐99 m red blood cell scintigraphy, all of which were negative. Subsequent ileoscopy showed an eroded anastomosis and proximal telangectasia, which were both successfully treated …

中文翻译：

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静止期克罗恩病患者反复出现大量便血

一名患有严重克罗恩病的 61 岁男性因反复发作的大量便血多次入院就诊。他有很长的克罗恩病狭窄病史，需要在 24 岁时进行直肠结肠切除术和末端回肠造口术，并随后进行了 5 次小肠切除术。在初次就诊前 2 个月的回肠镜检查未发现活动性炎症的证据。患者最初因栗色大便就诊于急诊科，随后从回肠造口术发展为大量便血。腹部检查无压痛。患者紧急进行了食管胃十二指肠镜检查和上推小肠镜检查，随后进行了锝-99 m红细胞闪烁显像，结果均为阴性。随后的回肠镜检查显示吻合口腐蚀和近端毛细血管扩张，