Clinical presentation

A 71-year-old man attended accident and emergency with a 1-day history of rectal bleeding without associated abdominal pain, change in bowel habit or history of GI disease. On admission, his haemoglobin was normal at 147 g/L with normal platelets of 194×10⁹/L. There was a raised white blood cell count of 12.2×10⁹/L (normal range 4.5−11×10⁹/L) and normal C-reactive protein of 2.2 mg/L. His urea and electrolytes and liver function tests were normal. The patient had no recent changes to his regular medication and did not take non-steroidal anti-inflammatory drugs, antiplatelet or anticoagulant medications. He reported feeling well with no fevers or weight loss and denied any previous similar episodes. He had recently undergone a minimally …