Differential Diagnosis for Profuse, Massive PR Bleeding with Hyperemic and Reddish Area in Transverse Colon
- Single most likely diagnosis
- Diverticulosis: This condition is a common cause of massive lower gastrointestinal bleeding, especially in adults over 40 years old. The presence of a hyperemic and reddish area in the transverse colon during colonoscopy could indicate a diverticular bleed.
- Other Likely diagnoses
- Crohn’s disease (C): While Crohn's disease can cause bleeding, it is more commonly associated with chronic symptoms such as diarrhea, weight loss, and abdominal pain. However, it could be considered if there are other signs of Crohn's disease.
- Ulcerative Colitis (D): Similar to Crohn's, ulcerative colitis can cause rectal bleeding, but it typically presents with chronic diarrhea and other symptoms.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Aortoenteric fistula (A): Although rare, an aortoenteric fistula is a life-threatening condition that requires immediate attention. It is a connection between the aorta and the intestine, which can cause massive bleeding.
- Ischemic colitis: This condition occurs when there is insufficient blood flow to the colon, which can cause bleeding and other symptoms.
- Rare diagnoses
- Vascular ectasias (angiodysplasia): These are abnormal blood vessels in the colon that can cause bleeding, especially in older adults.
- Infectious colitis: Certain infections can cause colitis and subsequent bleeding, although this would typically be accompanied by other symptoms such as diarrhea and fever.