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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 328:1107-1114 April 15, 1993 Number 15
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Case 15-1993— A 58-Year-Old Man with Recurrent Lower Gastrointestinal Bleeding for over Two Years
Cheryl J. Bunker, and Christophe Girardet

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Presentation of Case

A 58-year-old man was admitted to the hospital because of recurrent gastrointestinal bleeding.

The patient had been in stable health until 27 months earlier, when hematochezia developed. His physician found that he was depressed and anxious. Physical examination was negative; a stool specimen was negative for occult blood. The hematologic and blood-chemical laboratory findings throughout the patient's course are presented in Table 1 and Table 2, respectively. An upper gastrointestinal series showed only a small hiatus hernia. Examination with a fiberoptic colonoscope to the level of the cecum revealed no abnormality. Ferrous sulfate was prescribed.

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Table 1. Hematologic Laboratory Findings.

 
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Table 2. Blood . . . [Full Text of this Article]

 
Differential Diagnosis

Clinical Diagnosis

Dr. Cheryl J. Bunker's Diagnosis

Pathological Discussion

Anatomical Diagnosis

References


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