Acute Pseudodiverticular Bleeding from a Tuberculous Scar of the Terminal Ileum

Acquired ileal diverticuli are an uncommon condition and the diagnosis is often difficult when bleeding occurs from this source. Tuberculosis mainly involves the terminal ileum and has associated complications such as obstruction, perforation, stricture and bleeding, but rarely presents with pseudodiverticuli with a fistula. A 42-year-old man presented with massive hematochezia for three days. The patient had a history of pulmonary tuberculosis with complete recovery two times. Emergency sigmoidoscopy, esophagoduodenoscopy and computed tomography of the abdomen could not detect the bleeding focus. The next day, colonoscopy was performed, which demonstrated the opening of pseudodiverticuli at the terminal ileum. There was an exposed vessel in one of the pseudodiverticuli. The patient was treated successfully with epinephrine and ethanol sclerotherapy. A subsequent colonoscopy showed that the exposed vessel was completely healed seven days later. We report a case of acute pseudodiverticular bleeding from a tuberculous scar of the terminal ileum with a review of the relevant literature.