Megaloblastic anaemia after pelvic radiotherapy for carcinoma of the cervix.

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.