Cameron Ulcers: You Will Find Only What You Seek

Excerpt

An obese 71-year-old Caucasian woman presented for evaluation a 2-year history of severe, unexplained iron deficiency anemia and recurrent melena. She was first diagnosed with iron deficiency anemia four years prior to presentation and was treated aggressively with oral and intravenous (IV) iron supplementation. During this time, she underwent several procedures at three different hospitals in an attempt to discover a cause of her anemia, including four upper endoscopies, three colonoscopies, a capsule endoscopy, an abdominal ultrasound, a technetium-99-tagged red blood cell scan and multiple chest X-rays. She also received more than 16 blood transfusions and over six IV infusions of iron for recurrent anemia. Despite these clinical and endoscopic evaluations, a definitive source of her gastrointestinal bleeding remained elusive. As a result, her hemoglobin levels continued to remain low, despite aggressive iron and blood replacement therapies (Fig. 1).

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