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Canadian Journal of Gastroenterology
Volume 16, Issue 12, Pages 855-859
Brief Communication

Iron Deficiency Anaemia Caused by Nonspecific (Idiopathic) Small Bowel Ulceration: An Uncommon Presentation of an Uncommon Disease

Gabriele Capurso,1 Edith Lahner,1 Nadia Pallotta,2 Francesco Panzuto,1 Gianfranco Delle Fave,1 and Bruno Annibale1

1Digestive and Liver Disease Unit II Medical School, Ospedale Sant’Andrea, Rome, Italy
2Department of Clinical Science, University La Sapienza, Rome, Italy

Received 5 July 2002; Accepted 7 October 2002

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Ulcers of the small bowel are rare, and in most cases are due to infections, inflammatory bowel diseases, malignancies or drugs. When none of these causes is recognized, they are classified as ‘nonspecific’ or idiopathic. Such lesions are uncommon, and in most cases present with occlusion. A case of a middle-aged woman with iron deficiency anemia due to occult bleeding, with negative gastroscopy and colonoscopy is presented. The diagnosis of a small bowel pathology resembling Crohn’s disease was made by small bowel follow through and small intestine contrast ultrasonography. An ileal ulcer was identified at surgery, and after resection the patient experienced a stable recovery from the anemia without ulcer recurrence. Neither histology nor clinical or biochemical features suggested the diagnosis of an inflammatory bowel disease. Other possible causes were unlikely and the lesion was therefore diagnosed as idiopathic. This report also focuses on the need and the modality to investigate the small bowel in iron deficiency anemia patients.