Synchronous Obstructed Right Para-Duodenal Hernia, and Lower Gastrointestinal Hemorrhage due to Crohn's Ileitis

ABSTRACT We report a 55-year-old man who presented with acute small bowel obstruction and hematochezia. He was receiving medications for type 2 diabetes mellitus, chronic renal disease, and ischemic heart disease. Initially, we diagnosed terminal ileitis during colonoscopy. The gastrointestinal bleeding ceased after endotherapy, and the patient underwent surgery for an obstructed internal hernia. Gastrointestinal bleeding recurred on day 5 post-surgery. Mesenteric angiography failed to detect any active bleeding. Histopathological evaluation of the surgical specimen after an ileo-colonic resection led to a diagnosis of Crohn's ileitis.