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Question of the Day

Assess your Gastroenterology knowledge with our question of the day.

An 18-year-old man was seen on a Friday night at the Emergency Department. He had been brought in by his friends who reported that he had collapsed in a public bar after vomiting. Friends had noted that the vomitus was bright red.

He reported a history of familial adenomatous polyposis (FAP) for which he had undergone a prophylactic colectomy with the formation of an ileo-anal pouch some years previously.

On examination he looked well, blood pressure 120/80 mm/Hg with no postural drop, pulse rate 70 beats per minute. The remainder of the examination including per rectal examination was unremarkable.

Haemoglobin 13.9 g/dl (13-18)
White blood cells 6 x 109/l (4-11)
Platelets 200 x 109/l (150-400)

An upper gastrointestinal (GI) endoscopy was normal.

What should be the next step in his management?

(Please select 1 option)

Colonoscopy
Discharge
Enteroscopy
Referral to surgical team
Repeat upper gastrointestinal endoscopy

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