A 57-Year-Old Woman With Bloody Diarrhea

Derik L. Davis, MD; Harvey Stern, MD; Helen T. Morehouse, MD

Disclosures

August 16, 2017

Editor's Note:

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 that you would like to suggest for a future Case Challenge, please contact us.

Background

A 57-year-old woman presents to the emergency department (ED) with a 3-day history of colicky lower-abdominal pain and diarrhea. She describes four or five episodes a day of soft diarrhea with blood mixed throughout. She reports no fever, vomiting, or pain with defecation. Her last bowel movement occurred earlier in the day, about 2 hours before her arrival at the ED. She also mentions having had intermittent episodes of bloody diarrhea over the past several months, but none that were this severe.

The patient's surgical history is notable only for cesarean deliveries; she reports no other significant medical history or contributory family history. She has no known drug allergies and takes no medications. She admits to smoking tobacco and drinking alcoholic beverages on the weekends.

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