Fig. 4

A Intraoperative endoscopy was performed during the second surgery. B (a) Intraoperative findings showed no obvious intestinal necrosis, but the terminal ileum wall on the 25 cm oral side from the ileocecal valve was hard and thickened (arrowhead). A laparoscopic trocar was inserted 5 cm orally from there (arrow). (b) Intraoperative endoscopic observation on the anal side confirmed the presence of the deepest longitudinal ulcer in the terminal ileum, where the bleeding site was expected. C Observation of the oral small intestine revealed no ulcerative lesions that could have caused the hemorrhage