Adhesive subacute small bowel obstruction presenting with gross rectal bleeding

The pathogenesis of massive lower gastrointestinal bleed (LGIB) due to angio-dysplasia and ulceration is rare and not well understood. We discuss an unusual presentation of a child with painless massive LGIB arising from chronic intestinal adhesions causing subacute small bowel obstruction and angio-dysplastic ulceration but without any clinical or radiological evidence of bowel obstruction.