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Dr. John C. Lamattina (Surgery): An 81-year-old man was admitted to this hospital because of massive rectal bleeding.
He had been in his usual state of health until 4 a.m. on the day of admission, when he awoke with a feeling of abdominal fullness, nausea, and rectal urgency. He passed a mixture (estimated volume, 0.7 liter) of bright-red blood and soft stool through the rectum. Emergency medical services were called. On their arrival, the blood pressure was 102/86 mm Hg, the pulse 46 beats per minute (which rose to 86), the respiratory rate 20 breaths per minute, and the oxygen
Differential Diagnosis
Sources of Rectal Bleeding
Causes of Rectal Bleeding
Surgical Approach
Resuscitation
Diagnostic Studies
Critical Care during Transport
Jejunal Diverticulosis
Clinical Diagnosis
Dr. David G. Forcione's Diagnosis
Intraoperative Decision Making
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Gastrointestinal Unit (D.G.F.); the Division of Trauma, Emergency Surgery, and Surgical Critical Care (H.B.A.); and the Departments of Radiology (S.P.K.) and Pathology (J.M.), Massachusetts General Hospital; and the Departments of Medicine (D.G.F.), Surgery (H.B.A.), Radiology (S.P.K.), and Pathology (J.M.), Harvard Medical School.
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