MDM //

This patients complaint of GI bleeding at this time does not appear to be from an emergent etiology. No emergent treatment is indicated. The patient is well appearing, with normal vital signs. No hypotension. No indications for blood transfusion. The patient has good cap refill, blood pressure, and skin tone suggesting no significant anemia. No active sources of bleeding are seen at this time. There is no significant hematemesis or melena or hematochezia. Patient does not have a history of cirrhosis or varices. Patient is not on any blood thinners such as coumadin or lovenox or xarelto to increase the risk of life threatening hemorrhage. This does not appear to be posterior nasal epistaxis causing the symptoms. Nares are clear. Lungs are clear with no evidence of hemoptysis or ARTERIOVENOUS MALFORMATION in the lung or bronchoarterial fistulas; are unlikely in this patient. Rectal exam shows no evidence of bleeding at this time. Possible etiology for self resolving bleeding are: mallory weiss tear vs arteriovenous malformation vs diverticulosis vs hemorrhoids vs anal fissures; at this point do no appear to be life threatening.



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