Haematochezia worsened despite medical treatment for 2 months and proctocolectomy with a permanent ileostomy was performed.
A 50-year-old Sri Lankan man presented with a 3-month history of diarrhoea, haematochezia and weight loss of 20kg.
We present a case of persistent severe haematochezia in a patient with CCS, successfully managed with Proctocolectomy.
The clinical examination found haematochezia
and progressive weight loss.
She had been compliant to her oral hematinics therapy and denied any history of dysuria, haematuria, haematemesis, or haematochezia
. A recent peripheral blood film revealed normochromic, normocytic anaemia, and serum ferritin was normal.
and fever may also occur.(2) Many predisposing factors are held responsible for the occurrence of GIMN.
Symptoms may include bright red blood in stools (Haematochezia
), weakness, abdominal tenderness or pain, and even anaemia in some cases.
A 13-year-old boy presented with a 1-year history of a gradually distending abdomen that was associated with constitutional symptoms, haematemesis and haematochezia
that were exacerbated after taking traditional medicament.
Greene (2012) also reported clinical symptoms observed in the study along with rapid dehydration, peripheral vascular collapse, tachypnoea, irregular pulse, haematochezia
, haematemesis, epistaxis, widespread petechiae, hepatic and renal failure and subsequently death.
Melena was the most common presenting manifestation followed by petechiae and haematochezia. Further, it is observed that petechial rash is the most common presentation in severe thrombocytopenia.
Distribution of Bleeding Manifestations in different Platelet Count Bleeding Platelet Count (/[mm.sup.3]) Total Manifestations (14) < 20,000 20,00050,000 > 50,000 (n=9) (n=17) (n=24) Haematochezia 1 2 -- 3 Melena -- 3 2 5 Petechiae 2 1 -- 3 Haematemesis -- 1 -- 1 Haematuria -- 1 -- 1 Epistaxis 1 -- -- 1 Total 4 8 2 14 Table 6.