Double Trouble

Gastrointestinal System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This patient\u0027s history has two important complaints: a lump in the right loin and multiple episodes of rectal bleeding.\n\nThe rectal bleeding is almost certainly due to a gastrointestinal (GI) lesion. The loin lump on the other hand could be due to a musculoskeletal, dermatological or even a renal lesion.\n\nThe question here is whether these complaints are due to a single pathology - or whether two unrelated pathologies are involved.\n\nThe next point of note is the recent rapid enlargement of the lump - a potentially sinister feature which warrants a meticulous physical examination.\n\nExamination shows that the lump is most likely of muscular origin. In this context, the muscular tumors most likely to show a rapid enlargement are rhabdomyomas, desmoid tumours and rarely, fibromas.\n\nThe last (but not least) point of note is the presence of multiple polyps upon rectal examination - this is strongly suggestive of a GI polyposis syndrome. Further visualization of the GI tract via colonoscopy a"}]}

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