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Obscure GI bleeding in a young man
  1. Fady Daniel1,
  2. Roni Aoun1,
  3. Rayan Rammal2
  1. 1Internal Medicine, Division of Gastroenterology and Hepatology, American University of Beirut, Beirut, Lebanon
  2. 2Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon
  1. Correspondence to Dr Roni Aoun, Internal Medicine, division of Gastroenterology and Hepatology, American University of Beirut, Beirut 1107 2020, Lebanon; ronigaoun{at}

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Clinical presentation

A 27-year-old healthy man presented with a 3-week history of melena along with iron-deficiency anaemia (haemoglobin: 60 g/L). Upper endoscopy and colonoscopy were performed and were normal. The patient was referred for enteroscopy after capsule endoscopy revealed the presence of blood in the proximal jejunum without visualisation of an underlying lesion.

On further questioning, patient denies having any GI or extraintestinal symptoms prior to onset of melena. He denied having weight changes and had no recent history of non-steroidal anti-inflammatory drugs use.

Push enteroscopy was performed using a PENTAX paediatric colonoscope. At 90 cm beyond the pylorus, note was made of a semicircumferential mass occupying three to …

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  • Contributors FD, RA and RR identified and managed the case. FD planned and supervised the workflow. FD was also the guarantor of the study. RA performed the literature review, wrote the manuscript and adjusted images quality to meet the journal requirements. RR provided pictures of surgical pathology specimen as well as histopathology slides (along with their descriptions).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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