Author: Mohamed Nasreddin, Mohamed Hanafy / Editor: Sarah Edwards / Codes: GP1, HP1, MHC3, SLO1, SLO2 / Published: 03/04/2025
A 17-year-old female patient recently diagnosed with iron deficiency anaemia presents to the Emergency Department (ED) complaining of diffuse lower abdominal pain and constipation.
The patient is generally well with normal vital signs: HR 99 bpm, BP 110/60, Spo2 on RA 97%, RR 18, Temp 37c.
Abdominal examination shows lax soft non-distended abdomen with no tenderness or rebound tenderness.
Since the patient is a young adult female in childbearing period, the radiologist has approved doing plain erect abdomen X-ray first showing an apparent radiopaque shadow of the large bowel (as attached).
One Response
• This is not a presentation that I have ever seen; it was great to learn about it
• My first thought was that the opacity was iron tablets from iron overdose (but this was not an option)
• It goes without saying that a pregnancy test should be done early in the presentation
• I did not know that geophagia and ice ingestion were strongly linked to iron deficiency (but I did know that elephants sometimes seek iron-rich soil to eat)
• This is the sort of quirky case that I will not forget