Case Discussion 20112016 - 2 - PR Bleeding

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20 Nov 2016 - General

A middled aged gentleman, with background of hypertension, type 2 diabetes mellitus, hypercholesterolaemia, smoker of 10 pack years history, and prostate cancer, was admitted to hospital due to worsening of fresh PR bleeding for the last week. Patient was having external beam radiation for his prostate cancer around 5 months ago. He started to have some intermitent PR bleeding since around 3 weeks ago, but the PR bleeding was worsening for the last week, with the frequency of 4-5 episodes of PR bleeding per day. His blood tests did showed a drop of haemoglobin (Hb) from around 11.5 to 9.  What will be your working diagnosis for this gentleman ? What are the investigations for him? What would be your proposed management plan for him ? Will this medical condition recur again in the future ??