Iron deficiency anaemia and lower abdominal pain in a patient with resected Meckel's diverticulum

A 21-year-old male presented with worsening, intermittent lower abdominal pain associated with 10 kg weight loss over the preceding 6 months. His past medical history was significant in view of a prior 12-cm small bowel resection secondary to subacute intestinal obstruction, with Meckel's diverticulum confirmed as the underlying cause on histology. Upon investigation, iron deficiency anaemia was noted, but oesophagogastroduodenoscopy and ileocolonoscopy were normal. Cross-sectional imaging only showed the surgical clips. However, on capsule endoscopy, the capsule was retained and an ischaemic small bowel loop was resected laparoscopically. Small bowel anastomotic ulcers are either rare or underdiagnosed, have a wide differential diagnosis and as for other small bowel pathology, are best diagnosed via capsule endoscopy.