Gastrointestinal bleeding in the tropics: Look for the hookworm

Hookworms are recognised as a cause of iron-deficiency anaemia in endemic areas. They are, however, often not considered in the differential diagnosis of overt gastrointestinal bleeding. We report the endoscopic diagnosis of hookworms as the cause of gastrointestinal bleeding in three patients, two of whom had frank haemorrhage with one presenting in hypovolemic shock. Hookworm infestation is an important treatable cause of gastrointestinal bleeding in tropical countries.