PR Bleeding

Question 1

Differentials

Answer 1

CA
Unintentional LOW/LOA
Back pain
Local spread
LLBB

Haemorrhoids
Lump at anus
Digitation

Fissure
Sharp pain outlasting defecation

IBD
LOA/LOW
Joint pain
Dry mouth and eyes
FHx

Blood
Clotting problems
Blood thinners

Diverticulitis
Fever
Pain
Long standing constipation

Infection
Diarrhoea
Foreign travel

Question 2

Investigations

Answer 2

Bloods
FBC
Clotting
CEA
Group and save
U&E
LFT

ABG
Lactate

ECG
AF emboli in mesenteric ischemia

Imaging
Colonoscopy and Bx or CTC
XRay
USS
CT TAP
Mesenteric angiogram

Stool
Culture
SFR