A case of primary ulceration of the ileum in the absence of a Meckel's diverticulum or ectopic gastric tissue is described. Although this condition is infrequently observed, it should be considered as a potential cause of massive rectal bleeding, iron deficiency anemia of unknown cause, perforation, or partial small bowel obstruction. The diagnosis is normally made at surgery. Segmental resection with end-to-end anastomosis is the treatment of choice. Recurrence following surgery is rare.

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