Case No. 45

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Case No. 45

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Chief Complaint:

Painless rectal bleeding

Published: June 23, 2017
Case No. 45
Author: Code_Brown
CASE SCENARIO

A mother brings her child to the doctor for evaluation of rectal bleeding. The patient is 1 year 9 months old and has no past medical history. All of his immunizations are up to date. Mom reports she noticed blood in his diaper yesterday, and again today. He is feeding well, has no fevers , diarrhea, or vomiting, and appears comfortable. There is no recent travel. No other family members are experiencing bloody bowel movements. On examination his vital signs are all within normal limits. He appears comfortable and non-toxic. Cardiopulmonary exam does not reveal any abnormalities. His abdomen is soft, non-distended, non-tender to palpation throughout, and has normal bowel sounds. Capillary refill is normal. GU exam is benign.

QUESTION

Which imaging modality should you obtain to confirm the diagnosis?

Abdominal xray
Abdominal non-contrast CT
Abdominal contrast CT
Air enema
Abdominal Ultrasound
Nuclear medicine scan