A 67-year-old man presents with recurrent passage of bright-red blood and clots. After initial fluid replacement, his blood pressure is 126/74 mmHg and pulse is 92 beats/minute, but he continues to pass approximately 250 mL of blood every 10 minutes and his haemoglobin is 86 g/L (130–170 g/L). He has no abdominal pain, previous inflammatory bowel disease or recent colonoscopy. Which one of the following is the most appropriate investigation to localise the active bleeding?
Keep going — a set of ten like this one, one at a time.
Practise moreMore from Cardiovascular
See allA 76-year-old man reports that for three months he has felt light-headed and has twice nearly fainted walking up the hill to the shops, together with a tight fe…
Pre-internship · common
A 34-year-old man who injects heroin presents with two weeks of fevers, sweats, a cough and pleuritic chest pain on both sides. His temperature is 39.2 °C, puls…
Clinical rotations · middle twist
A 52-year-old Aboriginal woman from a community in Cape York presents with a week of palpitations and breathlessness on walking to the store. She had several ep…
Pre-internship · middle twist
A 68-year-old man is brought in by his wife after his third collapse in a month. Each time he has been sitting watching television, has suddenly gone grey and s…
Clinical rotations · middle twist
A 79-year-old woman is admitted with ongoing lower gastrointestinal bleeding and a haemoglobin concentration of 72 g/L (reference range 115–155). She is receivi…
Pre-internship · middle twist