A 76-year-old man was admitted to the medical assessment unit with bleeding per rectum.
He was pain free and haemodynamically stable.
His past medical history included myocardial infarction two years ago, atrial fibrillation and chronic obstructive
pulmonary disease.
His medication included digoxin 125 µgrams per day, furosemide 40 mg per day, warfarin 3 mg per day and
salbutamol inhaler.
His haemoglobin was 9.6 g/dl on admission. However, ten hours later he suddenly became hypotensive and
was resuscitated with two units of Gelofusine and two units of blood.
An emergency GI endoscopy was inconclusive. An angiogram confirmed the diagnosis.
What is the most likely diagnosis?
Angiodysplasia Correct
Colonic tumour
Diverticular disease of the large bowel
Granulomatous ulceration, that is, Crohn’s disease
Ischaemic colitis
Colonic tumour
Diverticular disease of the large bowel and
Granulomatous ulceration pathology
can be identified at the endoscopy.
Ischaemic colitis can present with massive bleeding, but abdominal pain is a predominant feature.