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22 Oct 2016 - General

An elderly gentlmean, with background history of type 2 diabetes mellitus, hypertension, parkinson disease, hypercholesterolaemia, non alcohol fatty liver disease, was admiited due to 2 days history of malaena, general unwell, fatugue, and reduced in appetite. His long list of medication did included aspirin 75mg, with no other anti-coagulation or anti-platelet.  Blood test showed that patient had microcytic anaemia (Hb was 8.0, comparing to 11.5 3 months ago, a significant drop). Patient was haemodynamically stable on admission. He was treated with intravenous proton pump inhibitor infusion, for his stable upper gastrointestinal bleed. Gastroscopy was performed, showed a normal result, up to second part of duodenum. Patient had colonoscopy subsequently, also showed a normal large bowel. What should be we do next to further investigate the cause of his malaena ??

Yes Madhubabu kaaja aspirin may the contributory factor for the bleeding. With the presentation of melena, this patient is very likely suffering from gastrointestinal bleeding. But, both the gastroscopy and colonoscopy were not able to identify the source of bleeding. Small bowel can potentially be the source of gastrointestinal bleeding. Capsule Endoscopy will be the next step of investigation, which can visuali...
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