Severe Lower Gastrointestinal Bleeding in a Patient with Crohn’s Disease: A Case Report and Review of the Literature

Abstract Crohn’s disease (CD) very rarely presents with massive lower gastrointestinal bleeding (LGIB), which can make diagnosis difficult and management urgent. We report the case of a 32-year-old man with a known history of CD since 2011, who had been off treatment due to financial limitations. He arrived in critical condition with life-threatening rectal bleeding. Emergency surgery revealed multiple strictures in the terminal ileum, approximately 15 cm from the ileocecal valve. A 40-cm segment of bowel was resected, and a loop ileostomy was created. Thankfully, his postoperative course was smooth, and he was discharged within a week for continued outpatient follow-up. This case highlights a rare but serious complication of CD that may require surgical management. According to published reports, fewer than 100 similar cases involving massive LGIB from CD have been documented, making this an uncommon but important presentation for clinicians to recognize.