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A patient with anemia of obscure origin: Crohn's disease in disguise
Elena Dubcenco1, Khursheed N Jeejeebhoy, Cathy J Streutker
1Department of Medicine, University of Toronto and St Michael's Hospital, Toronto, ON, Canada.
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.
Investigations:
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.
Diagnosis:
Crohn's disease of the small bowel.
Management:
Laparoscopic segmental small-bowel resection with end-to-end anastomosis. Postsurgical treatment with Pentasa 4 g a day.
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