Strange Stool Color and Fatigue in a Man With COPD and Atrial Fibrillation

Asim Kichloo, MD; Dushyant Singh Dahiya, MD; Farah Wani, MD; Khalil Kanjwal, MD


April 12, 2021

Physical Examination and Workup

In the ED, the patient has a temperature of 98 °F (36.7 °C), a heart rate of 120 beats/min, a respiration rate of 18 breaths/min, and a blood pressure of 86/60 mm Hg. His oxygen saturation is 98% on room air.

Upon physical examination, his extremities are pale and cold. No peripheral edema is noted. Peripheral pulses are weak but palpable in all limbs. His abdomen is soft and nontender, with normal bowel sounds. Tachycardia is noted on auscultation of the chest, and rhonchi are audible in all lung fields.

Laboratory investigations reveal the following values:

  • Hemoglobin level: 6.9 g/dL (reference range, 13.5-17.5 g/dL)

  • Hematocrit: 40% (reference range, 41-50%)

  • White blood cell count: 7000 cells/µL (reference range, 4000-11,000 cells/µL)

  • Platelet count: 177,000 cells/µL (reference range, 150,000-400,000 cells/µL)

The fecal occult blood test result is positive. All other laboratory values are unremarkable. An ECG shows sinus tachycardia and no ST-segment changes. Echocardiography reveals a left ventricular ejection fraction of 60%-65%. Esophagogastroduodenoscopy (EGD) is performed. Figure 1 shows similar results as were seen in this case in another patient. Colonoscopy is also performed. Figure 2 is an example of similar findings as were seen in this case in another patient.

Figure 1.

Figure 2.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.