Pt presents with BRBPR.

 

---

PEARLS:

“Factors associated with a high morbidity rate are hemodynamic instability, repeated hematochezia, gross blood on initial rectal examination, initial hematocrit <35%, syncope, nontender abdomen (predictive of severe bleeding), aspirin or non- steroidal anti-inflammatory drug use (predictive of diverticular hemorrhage), and more than two comorbid conditions.”

Discharge

• Bleeding from hemorhhoids, anal fissures, or known IBD (hemodynamically stable)
• No gross blood on rectal exam (hemodynamically stable)
• Recent marathon completion

Admission

• Melena
• Significant anemia
• Hemodynamic instability