Acute Lower Gastrointestinal Bleeding
Acute Lower Gastrointestinal Bleeding
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DOI：
10.1056/nejmcp1603455
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发表时间：
2017-03-16
影响因子：
158.5
通讯作者：
Strate, Lisa L.
中科院分区：
文献类型：
--
作者：
Gralnek, Ian M.;Neeman, Ziv;Strate, Lisa L.
A 71-year-old woman with hypertension, hypercholesterolemia, and ischemic heart disease, who had a cardiac stent placed 4 months earlier, presents to the emergency department with multiple episodes of red or maroon-colored stool mixed with clots during the preceding 24 hours. Current medications include atenolol, atorvastatin, aspirin (81 mg daily), and clopidogrel. On physical examination, the patient is dia-phoretic. While she is in a supine position, the heart rate is 91 beats per minute and the blood pressure is 106/61 mm Hg; while she is sitting, the heart rate is 107 beats per minute and the blood pressure is 92/52 mm Hg. The remainder of the examina-tion is unremarkable, except for maroon-colored stool on digital rectal examination. The hemoglobin level is 9.3 g per deciliter, the platelet count 235,000 per cubic milli-meter, and the international normalized ratio 1.1. How should this patient's case be further evaluated and managed?
