Gastrointestinal System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"The elderly patient who presents with lower gastrointestinal (GI) bleeding is not an uncommon presentation in primary care.\n\nThe first priority should always be assessment of the hemodynamic status, followed by resuscitation as necessary; fortunately, this patient\u0027s vital parameters appear to be quite stable.\n\nDetermination of the likely underlying etiology should be next; in this regard, note that the blood was fresh, and well mixed with the fecal matter, favoring a colonic pathology.\n\nA malignancy of the colon is an important consideration here, given his age and history; other key possibilities include infectious colitis and ischemic colitis.\n\nNote that while diverticulosis (as opposed to acute diverticulitis) can also give rise to lower GI bleeding, this is typically painless, with few or no associated abdominal signs. Furthermore, inflammatory bowel disease is unlikely to present for the first time at this age.\n\nColonoscopy is a good next step; this reveals a large, necrotic-appea"}]}

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