Case Study 26092016Created by:
An elderly gentleman, with background of previous stroke, hypertension, type 2 diabetes mellitus, history of prostate cancer (received external beam radiation last year), and depression, presented to casualty due to 1 month history of intermittent fresh per rectum bleeding. Patient denied any constipation or diarrhoea or any weight loss. He has no abdominal pain. The only symptom was fresh PR bleeding intermittently, can be up to 5-6 episodes per days. His HB was dropped to around 8.5 g/dl, comparing to was around 11.5 g/dl around 6 months ago. No other abnormality in other blood test, with normal renal function , liver function and CRP. What will be your differential diagnosis for his symptom ?? What is the investigation of choice and the management plan ??