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Segmental dilatation of small bowel presenting with severe anaemia: a diagnostic puzzle
Ankita Jain1, Mike Cosgrove2, Daniel Aronson3
1Department of Paediatrics, Abertawe Bro Morgannwg University Health Board, Swansea, UK.
Insights
A 7-year-old boy with severe iron deficiency anemia underwent surgery for intestinal blockages. Successful resection resolved his anemia, eliminating the need for further transfusions or iron therapy.
Area of Science:
- Pediatric Gastroenterology
- Surgical Gastroenterology
Background:
- Severe iron deficiency anemia in children can stem from various underlying causes.
- Prompt diagnosis and appropriate management are crucial for pediatric patients.
Observation:
- A 7-year-old boy presented with severe iron deficiency anemia, extreme pallor, lethargy, and tiredness.
- Initial treatment with iron supplements and blood transfusion yielded suboptimal response.
Findings:
- Barium meal revealed dilated ileum segments with distal stenoses, necessitating surgical resection.
- Histology of the resected ileum was inconclusive for inflammatory bowel disease, malignancy, or vascular malformation.
Implications:
- Surgical intervention for obstructive intestinal lesions can effectively resolve severe iron deficiency anemia in pediatric cases.
- This case highlights the importance of thorough investigation beyond initial treatments for persistent anemia.
Abstract:
A 7-year-old boy presented to Paediatric outpatient with worsening lethargy and tiredness. On examination he had extreme pallor. Blood investigations confirmed severe iron deficiency anaemia. He was started on iron supplements and received blood transfusion. However, the response to iron treatment was suboptimal, he therefore underwent extensive workup for the cause of iron deficiency anaemia. The barium meal showed dilated segments of ileum with two distal stenoses. The surgical resection of the involved segment was performed with end to end anastamosis. Histology of the resected segment was inconclusive of inflammatory bowel disease, malignancy or vascular malformation. The child has remained well since surgery with no further blood transfusion or iron therapy.
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