{"ops":[{"insert":"A 70 year old lady presents with generalised weakness and fatigability for 8 months. She had no other complaints, while her medical and surgical histories are unremarkable.\n\nHer FBC is significant for a Hb of 5.4 g\/dL, along with a low MCV, MCHC and MCH. Her electrolytes, liver functions, renal functions, and coagulation profiles are normal.\n\nRepeated questioning reveals a history of intermittent tarry colored stools. Initial and repeat upper GI endoscopies are normal, as is a colonoscopy.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-S-027_en.png"}},{"insert":"\n"}]}
2
Investigate
Barium Follow-Through
{"ops":[{"insert":"You realize that a barium series may obscure any overt bleeding, and potentially interfere with subsequent investigations.\n"}]}
Capsule Endoscopy
{"ops":[{"insert":"There is active bleeding from the proximal jejunum; the mucosa in that region appears nodular, polypoid, and eroded. The remainder of the jejunum shows thickening of the valvulae conniventes.\n"}]}
