A 71-year-old woman was treated with radiotherapy for carcinoma of the cervix. Nine year later she was found at laparotomy to have a thickened narrow ileum. At the time she had an iron-deficiency anaemia and when this was treated the blood picture changed to that of a severe megaloblastic anaemia. This was due to cobalamin deficiency resulting from malabsorption of cobalamin by the damaged ileum.
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