Interesting cause of massive small-bowel bleed in a tropical?country

摘要

A 55-year-old man presented with recurrentepisodes of melena with easy fatigability and shortnessof breath for 2 months. Physical examination resultswere unremarkable except for signs of anemia.Routine investigations revealed hemoglobin 3.2 g/dL,hematocrit 16.4%, mean corpuscular volume 65 fL,and white blood cell count 3100 with 21% neutrophils,49% lymphocytes, 10% monocytes, and 20% eosinophils (Table 1). The result of a guaiac test for stoolwas positive. A stool test for ova and parasitesyielded negative results. The patient’s condition wasstabilized with packed red blood cell transfusions(4 units were transfused in total). EGD andcolonoscopy showed normal results.