Haemorrhage from idiopathic annular ulcers of the small intestine

Annular small bowel ulceration is rare. We report three patients who presented with signs of chronic gastrointestinal blood loss. In two patients the main presenting symptom was intermittent abdominal pain while the third patient subsequently developed abdominal pain during the course of investigation. Preoperative localisation of the source of haemorrhage proved difficult in each case. However in all three patients an easily identifiable lesion was found at laparotomy. We believe that laparotomy should be undertaken more readily in the investigation of patients with the combination of abdominal pain and gastrointestinal bleeding as these patients are likely to have an anatomically identifiable cause for their symptoms.