Obscure gastrointestinal bleeding can present a diagnostic challenge.

We report the case of an 84-year-old male with chronic kidney disease and anticoagulated atrial fibrillation, presenting with anemia and recurrent melena.

Initial endoscopic evaluation, including gastroscopy and colonoscopy, revealed no findings. Capsule endoscopy subsequently identified fresh blood in the proximal jejunum.

Anterograde single-balloon enteroscopy was performed, revealing a 5 mm lymphangiectasia in the proximal jejunum, approximately two meters from the dental arcade, with active oozing at its base, which was treated with the placement of a hemoclip, with good results.

This case highlights the importance of advanced endoscopic techniques in the diagnosis and treatment of obscure gastrointestinal bleeding.