Elusive Nexus: A Case of Megaloblastic Anaemia Secondary to Jejunal Diverticulosis

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Jejunal diverticulosis is a rare but often underdiagnosed condition that can lead to significant complications, including malabsorption and megaloblastic anaemia. Its non specific symptoms and the lack of routine small bowel imaging contribute to frequent diagnostic delays. This case report underscores the clinical importance of recognising jejunal diverticulosis as a potential cause of unexplained macrocytic anaemia and highlights the need for timely diagnosis and management. A 35-year-old male presented with progressive fatigue, pallor and abdominal discomfort for three months. Laboratory findings revealed macrocytic anaemia {Haemoglobin (Hb) 7.8 g/ dL, Mean Corpuscular Volume (MCV) 108 fL} and severe vitamin B12 deficiency (120 pg/mL). Abdominal Computed Tomography (CT) imaging identified multiple jejunal diverticula and a barium meal follow-through confirmed the diagnosis. The patient’s anaemia was attributed to vitamin B12 malabsorption due to bacterial overgrowth in the diverticula. Treatment with intramuscular vitamin B12 led to complete symptomatic and haematological recovery over three months. This case highlights the necessity of considering small bowel diverticulosis in patients with persistent macrocytic anaemia when conventional causes have been ruled out. Early recognition through targeted imaging can prevent complications and guide appropriate management. Given the rarity of reported cases, particularly in younger patients, this case contributes valuable insight into the spectrum of presentations and reinforces the need for heightened clinical awareness.