Pattanashetti N, Gupta S, Rana S, Dahiya D, Das A, Kumar V, Rathi M, Kohli H S, Gupta K L, Ramachandran R
Department of Nephrology, PGIMER, Chandigarh, India.
Department of Internal Medicine, PGIMER, Chandigarh, India.
Indian J Nephrol. 2019 Mar-Apr;29(2):132-134. doi: 10.4103/ijn.IJN_360_17.
Massive rectal bleeding is an uncommon presentation of ileal tuberculosis (TB). We report an uncommon cause of anemia in a post-renal transplant patient due to massive lower gastrointestinal (LGI) bleed. The index case had a normal upper and LGI endoscopy, but the technetium labeled red blood cell scan showed active bleeding from terminal ileum and caecum. Microscopic examination of the resected specimen revealed tubercular granuloma with acid-fast bacilli. Intestinal TB should be a differential diagnosis for massive LGI bleed in immunosuppressed patients in developing country.
大量直肠出血是回肠结核（TB）的一种罕见表现。我们报告了一例肾移植术后患者因大量下消化道（LGI）出血导致贫血的罕见病因。该病例的上消化道和下消化道内镜检查均正常，但锝标记红细胞扫描显示回肠末端和盲肠有活动性出血。切除标本的显微镜检查发现结核性肉芽肿及抗酸杆菌。在发展中国家，肠道结核应作为免疫抑制患者大量LGI出血的鉴别诊断之一。
