This is a report of a 27-year-old Nigerian male who presented with massive lower gastrointestinal haemorrhage requiring seven units of whole blood to finally stabilize him. Physical examination and other laboratory investigations as well as sigmoidoscopy were not helpful in establishing a diagnosis. Barium enema had indicated a suspicious narrowing of the transverse colon which led to advising laparotomy. The definitive diagnosis was established following laparotomy and biopsy, histology of which revealed tuberculosis. Following the institution of anti-tuberculous therapy the patient's response was outstandingly remarkable.
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