A patient with anemia of obscure origin: Crohn's disease in disguise.
BACKGROUND
A 65-year-old white Mediterranean male with a 10-year history of intermittent anemia, who was otherwise completely asymptomatic, was referred to our hospital in March 2004. He had a medical history of beta thalassemia and fecal occult blood tests had occasionally been positive.


METHODS
Fecal occult blood test, laboratory investigations, esophagogastroduodenoscopy, colonoscopy with retrograde ileoscopy, mesenteric angiography, small-bowel series, CT scan of the abdomen and pelvis, Meckel's scan, and capsule endoscopy. Laparoscopic surgery followed by macroscopic and microscopic histopathologic examination of samples obtained during the procedure.


METHODS
Crohn's disease of the small bowel.


RESULTS
Laparoscopic segmental small-bowel resection with end-to-end anastomosis. Postsurgical treatment with Pentasa 4 g a day.
Dubcenco
Elena
E
Department of Medicine, University of Toronto and St Michael's Hospital, Toronto, ON, Canada.
Jeejeebhoy
Khursheed N
KN
Streutker
Cathy J
CJ
Zalev
Arthur H
AH
Garvey
M Bernadette
MB
Kim
Young-In
YI
Baker
Jeffrey P
JP
D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003113:Colonoscopy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D009780:Occult Blood; D017086:beta-Thalassemia / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine