Case History:
We present a 43-year-old male with a past medical history of hypertension, dyslipidemia, benign prostate hyperplasia, and internal hemorrhoids who presented to the emergency department (ED) for two episodes of bright red blood per rectum. He initially attributed his bleeding to his hemorrhoids. While in the ED, the patient had two further episodes of large bright red blood per rectum. He did not report any abdominal tenderness. In the ED, his vitals revealed a temperature of 36.8 C, heart rate of 99 beats per minute, blood pressure of 115/ 85 mmHg, and oxygen saturation of 97% on room air. His physical exam was benign except for bright red blood per rectum. Labs were notable for a hemoglobin of 11.8 g/dL and lactic acid of 2.9 mmol/L. CT angiography of the abdomen and pelvis was performed, which did not show any active gastrointestinal hemorrhage. The patient was started on Protonix 80 mg IV and 2 IV fluid boluses. The patient was admitted to the medical floor for treatment. GI was consulted, and the patient was scheduled for a colonoscopy.