Question: A 33-year-old man presented with episodic melena for 3 months associated with worsening exertional dyspnea and lethargy for 2 weeks. Clinical examination revealed marked conjunctival pallor. No masses were felt on abdominal or rectal examination. Hemoglobin level on admission was 3.9 g/dL and red blood cell indices revealed a microcytic and hypochromic erythrocyte profile. The patient received a blood transfusion in view of his symptoms. Esophagogastroduodenoscopy was normal and colonoscopy revealed melenic stains upon intubation of the terminal ileum.