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An 80-year-old man with caecal ulceration
  1. Benjamin Easton White,
  2. Adnan Al-Badri,
  3. John Nicholas Gordon
  1. Gastroenterology, Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust, Winchester, UK
  1. Correspondence to Dr Benjamin Easton White, Gastroenterology, Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust, Winchester SO22 5DG, UK; benjaminwhite{at}doctors.org.uk

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Clinical presentation

An 80-year-old man presented with a 3-month history of altered bowel habit, intermittent right iliac fossa abdominal discomfort and fluctuating perianal pain. He had a background of ischaemic heart disease and was taking atorvastatin, clopidogrel, bisoprolol, isosorbide mononitrate, fenofibrate, nicorandil and furosemide. Abdominal examination was unremarkable with rectal examination revealing a minor posterior fissure. He had a normochromic, normocytic anaemia of 108 g/L and a C-reactive protein of 5. Other bloods were normal.

A colonoscopy was arranged, which revealed a large area of deep ulceration in the ascending colon extending to the …

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