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April 1963

Circumferential Ulcerations of the Ileum: An Unusual Cause of Melena in Childhood

Author Affiliations

Charles B. Reiner, M.D., Children's Hospital, 561 S. 17th St., Columbus 5, Ohio.; Chief Resident Physician, Department of Pediatric Surgery, Children's Hospital, Ohio State University (Current address: Omaha, Neb.) (Dr. Schultz); Associate Pathologist, Children's Hospital; Assistant Professor of Research, Perinatal Institute, Ohio State University, Assistant Professor, Department of Pathology, Ohio State University College of Medicine (Dr. Reiner).

Am J Dis Child. 1963;105(4):375-380. doi:10.1001/archpedi.1963.02080040377009

Gastrointestinal bleeding is one of the causes of iron-deficiency anemia. However, locating the source of the bleeding may be very difficult. One of the lesions which may cause chronic blood loss is primary nonpeptic ulceration of the small intestine. As the name implies, no specific disease or pathological process has been found associated with these ulcers. Such primary ulcers may be found at any level in the small intestine and cause vague abdominal pain, melena, and secondary anemia.

In a recent review, Barnett 1 collected 74 cases of primary nonpeptic ulcerations occurring in the ileum. Since that time, 6 more individual case reports have been recorded.2-7 Only 10 of these 80 cases occurred in patients under 20 years of age.

The present case of a 7-year-old child with multiple circumferential ulcerations of the ileum producing anemia from chronic blood loss is herein reported for the following reasons: (1) rarity