An Unusual Finding on Computed Tomography in a Patient With Iron-Deficiency Anemia

Question: A 72-year-old man, with a history of primary biliary cirrhosis and moderate-severe chronic obstructive pulmonary disease requiring inhaled steroids, bronchodilators, and oxygen therapy, frequently presented with intermittent melena for 4 years. He underwent numerous gastroscopies, colonoscopies, and a capsule endoscopy in other hospitals with the diagnosis of esophageal varices and erosive gastritis during the past 4 years, and bone marrow aspiration showed iron-deficiency anemia. We could not review the endoscopic findings because endoscopy pictures available were black-and-white copies; the cause of the melena was unknown.