Gastroenterology
Case 43: A Faecal Occult Blood (FOB ) Positive Woman
CASE
A 64‐year‐old woman is identified as being faecal occult blood (FOB) positive by the Bowel Cancer Screening Programme (BCSP). She has no bowel symptoms but all three FOB tests were reported as positive. She has type 2 diabetes and hypertension but is otherwise well.
At colonoscopy she is found to have a 1.5‐cm pedunculated polyp in the sigmoid colon. This is snared, retrieved and sent to pathology. In addition she is found to have two further smaller polyps more proximally. Each of these is removed and sent for histology.
A week after the colonoscopy she re‐presents to the hospital with heavy rectal bleeding and mild shock (pulse 100 beats/min, systolic BP 100 mmHg). Her condition improves with 500 ml of colloid. Examination is then unremarkable.
Blood tests showed:
Hb 10.1 g/dL WCC 8.2 × 109/L Platelets 340 × 109/L Na 142 mmol/L K 3.2 mmol/L Urea 7.2 mmol/L Creatinine 110 µmol/L
QUESTION 1
Your score this session: 0 of 0
The bleeding is most likely due to: