A patient with anemia of obscure origin: Crohn's disease in disguise

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.