Gastrointestinal System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This child has presented with acute rectal bleeding.\n\nExamination reveals tachycardia and a delayed capillary refill time, but a normal blood pressure. These findings are suggestive of grade II hypovolemic shock.\n\nThus, the first priority is resuscitation and stabilization (similar to any other emergency presentation).\n\nOnce he is hemodynamically stable, the next step is to determine the cause of bleeding. The history yields several important clues in this regard - the first of which is the appearance of the blood.\n\nUpper gastrointestinal (GI) bleeding (i.e. duodenum and above) typically gives rise to malena, due to digestion of the blood in the small intestine. Bleeding from the terminal GI tract (i.e. from the sigmoid colon onwards) typic"}]}

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