12-30-2011, 09:34 AM
A 71 year old woman presents to the emergency room with complaints of bright red bleeding per rectum. She denies any abdominal pain, nausea or vomiting. She has a history of paroxysmal atrial fibrillation. Her medications include aspirin and beta blocker. About 10 days ago, she had a screening colonoscopy. She had a 3cm polyp in the sigmoid colon which was removed at that time. She reports that she did not experience any bleeding immediately after polyp removal and is concerned about this episode that occured so many days after the procedure. On physical examination she is afebrile . Abdominal examination is benign. Rectal examination reveals bright red blood and no palpable hemorrhoids. Patient is anxious about her diagnosis. Which of the following is the most appropriate statement?
A) ” Your bleeding is mostly secondary to ischemic colitis”
B) ” Bleeding can occur up to two weeks after polypectomy”.
C) ” Your bleeding is related to Aspirin use”.
D) ” We will have to repeat colonoscopy to confirm that a cancer has not been missed”
E) ” You will need diagnostic laporoscopy to evaluate the cause”
A) ” Your bleeding is mostly secondary to ischemic colitis”
B) ” Bleeding can occur up to two weeks after polypectomy”.
C) ” Your bleeding is related to Aspirin use”.
D) ” We will have to repeat colonoscopy to confirm that a cancer has not been missed”
E) ” You will need diagnostic laporoscopy to evaluate the cause”