Uncontrollable Rectal Bleeding Following Wegener’s Granulomatosis: A Case Report

Fatemeh  Fathi; Mohammad Reza  Nayeb; Fatemeh  Alipanah; Shadi  Sheikhalishahi; Ali  Jalili; Fahimeh  Shojaeifar

doi:10.18502/crcp.v10i3.20314

Fatemeh Fathi Critical Care Nursing Department, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Reza Nayeb Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Fatemeh Alipanah Nursing Department, Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Shadi Sheikhalishahi Nursing Department, Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Ali Jalili Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Fahimeh Shojaeifar Comprehensive Research Institute for Maternal and Child Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

DOI: https://doi.org/10.18502/crcp.v10i3.20314

Keywords: Wegener’s granulomatosis; Rectal bleeding; Intensive care unit

Abstract

Wegener’s granulomatosis is an autoimmune vasculitis affecting small and medium vessels, typically involving the respiratory tract and kidneys. Gastrointestinal manifestations are rare and pose diagnostic and therapeutic challenges. A 65-year- old man presented with severe abdominal pain and melena. He developed renal failure requiring dialysis and underwent multiple plasmapheresis sessions. During hospitalization, he experienced massive rectal bleeding and suspected hemoptysis. Endoscopy and colonoscopy revealed no obvious lesions, but CT angiography demonstrated reduced abdominal blood flow, leading to surgical resection of necrotic tissue. Despite intervention, bleeding persisted, and enteroscopy showed multiple ulcers in the jejunum and ileum. Gastrointestinal bleeding in Wegener’s granulomatosis may result from vascular damage or tissue necrosis and can cause life-threatening complications such as anemia and shock. Early recognition and timely treatment are essential to reduce morbidity and mortality.