Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 10 3 2025 12 09 127 132 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. 2025 09 21 2025 10 04 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-yearold 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. https://crcp.tums.ac.ir/index.php/crcp/article/view/1098 https://crcp.tums.ac.ir/index.php/crcp/article/download/1098/732