The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.
A 66-year-old woman with a history of factor V Leiden thrombophilia presents to the emergency department (ED) with deep venous thrombosis (DVT) after a 6-hour plane flight within the continental United States. During evaluation, she is found to be mildly anemic. Upon further discussion, she reports her bowel movements have increased from once daily to two to three times daily and have become slightly looser than normal over the past month. She also notes that in the past 2 weeks, her abdomen has felt "bloated and hard." She did not notice blood or mucus in her stool and denies pelvic or rectal pain, change in the stool caliber, recent weight loss, regular consumption of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), or any history of stomach ulcers.
The patient is an ex-smoker who is fit for her age and enjoys regular aerobic exercise. She lives alone and has two grown children who live overseas; however, she has not recently traveled abroad. She eats balanced meals, with regular consumption of red meat and vegetables. She takes no regular medications and has never had surgery. She has not been recently ill and has no history of recent antibiotic use. No family history of bowel cancer is noted; one of her daughters was diagnosed with ulcerative colitis as a teenager.
Medscape © 2021
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Jun H. Lee, Marc D. Basson. A Woman With DVT After a Flight, Anemia, and Bowel Changes - Medscape - Jun 29, 2021.