PATIENT: 73-year-old woman
CHIEF COMPLAINT: This patient was admitted with a diagnosis of acute rectal bleeding.
At the time of admission, the patient’s hemoglobin level was 7.5 g/dl; consequently, she received 3 units of packed red cells. Barium enema revealed a polypoid mass in the splenic flexure of the colon. Colonoscopic examination was planned to obtain biopsy specimens from the polypoid mass.
MEDICAL HISTORY: The patient had undergone open-heart surgery with insertion of a prosthetic mitral valve for mitral valve stenosis when she was 50 years old. There was no untoward bleeding associated with this surgical procedure. At 55 years of age, she again underwent major surgery for a possible ovarian tumor. The lesion was found to be a serous cystadenoma and was successfully removed. This operation also was performed without complications.
FAMILY HISTORY: Noncontributory.
DRUG HISTORY: The patient had taken Tagamet (cimetidine), and Lanoxin (digoxin).
PHYSICAL EXAMINATION: The patient was a pale and slightly obese woman. Surgical scars were seen over the abdomen and chest. Rectal bleeding was noted in examination.
PT= 13.5 sec (Normal 8-11.5)
aPTT = 60 sec (Normal 24-37.5)
Plt= 280,000 /μL (Normal 150,000-350,000)