{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T05:07:57Z","timestamp":1778476077008,"version":"3.51.4"},"reference-count":12,"publisher":"Korean Association of Internal Medicine","issue":"3","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002649","name":"Yeungnam University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002649","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["kjim.org"],"crossmark-restriction":true},"short-container-title":["Korean J Intern Med"],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:p>Background\/Aims: Acute lower gastrointestinal bleeding (LGIB) in Crohn\u2019s disease (CD) is a rare but potentially life-threatening complication. This study aimed to investigate the incidence and risk factors of rebleeding in CD patients with LGIB.Methods: We retrospectively analyzed 137 CD patients with acute LGIB from nine tertiary university hospitals in Korea from January 2000 to October 2020. Patient characteristics, disease features, and treatment modalities were assessed, and rebleeding incidence, clinical features, and risk factors were analyzed.Results: The median age of patients was 26.5 years, and the male-to-female ratio was 3.72:1. The median duration from diagnosis to first bleeding was 30.6 (0\u2013243) months. Ileocolonic involvement (72 patients, 53%) and inflammatory phenotype (85, 62%) were most prevalent. During index bleeding, 20 and 40 patients were receiving biologics and azathioprine\/6-mercaptopurine (AZA\/6-MP), respectively. Bleeding focus was confirmed in 58 patients, primarily with endoscopy (33 cases). Management included conservative therapy (115 cases, 84%), endoscopic treatment (11, 8%), embolization (5, 3%), and surgery (6, 4%). After the index bleeding, 77 (56.2%) patients started or changed AZA\/6-MP or biologics. Rebleeding occurred in 44 (32%) patients. The median time to recurrence was 13.0 (0.1\u2013209) months. Transfusion requirement was significantly associated with rebleeding in univariate (hazard ratio [HR] = 3.124, 95% confidence interval [CI] = 1.502\u20136.494; p = 0.002) and multivariate (HR = 3.857, 95% CI = 1.678\u20138.867; p = 0.001) analyses.Conclusions: Rebleeding incidence in patients with CD experiencing acute LGIB was 32%. Transfusion requirement is a significant risk factor for rebleeding.<\/jats:p>","DOI":"10.3904\/kjim.2025.348","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T07:53:44Z","timestamp":1777535624000},"page":"454-461","update-policy":"https:\/\/doi.org\/10.3904\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence and risk factors of rebleeding in Crohn\u2019s disease patients with acute lower gastrointestinal bleeding"],"prefix":"10.3904","volume":"41","author":[{"given":"Gabin","family":"Moon","sequence":"first","affiliation":[{"name":"1Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5799-7436","authenticated-orcid":true,"given":"Kyeong Ok","family":"Kim","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Noh","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seong Joon","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung Hoon","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seoul St. Mary\u2019s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang Hwan","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Mi","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong Sub","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Inje University College of Medicine, Busan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoo Jin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ki Bae","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"On behalf of the IBD Research Group of the Korean Association for the Study of Intestinal Diseases","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2270","reference":[{"key":"ref1","first-page":"85","volume-title":"Life-threatening hemorrhage and exsanguination from Crohn\u2019s disease. Report of four cases","author":"Cirocco","year":"1995"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2012.03.010"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000000804"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199103000-00004"},{"key":"ref5","first-page":"2177","volume-title":"Acute lower gastrointestinal bleeding in Crohn\u2019s disease: characteristics of a unique series of 34 patients. Belgian IBD Research Group","author":"Belaiche","year":"1999"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2018.19.6.1089"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5107(99)70479-7"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i19.2353"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3109\/00365528909091339"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1155\/2005\/269076"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2005.11679692"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.15495"}],"container-title":["The Korean Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/kjim.org\/upload\/kjim-2025-348.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2025.348","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/kjim.org\/upload\/kjim-2025-348.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T04:11:10Z","timestamp":1778472670000},"score":1,"resource":{"primary":{"URL":"http:\/\/kjim.org\/journal\/view.php?doi=10.3904\/kjim.2025.348"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.3904\/kjim.2025.348","relation":{},"ISSN":["1226-3303","2005-6648"],"issn-type":[{"value":"1226-3303","type":"print"},{"value":"2005-6648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]},"assertion":[{"value":"2025-10-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-01","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}