55 y/o male patient presenting with melena, intermittent constipation with no obstipation and episodes of vomiting with no hematemesis. Only comorbid is HIV on treatment with lower than detectable viral load and CD4 of 610. No prev surgery. Regular NSAID usage. The patient is stable but mild wasting noted with abdomen mildly tender epigastrically but not peritonitic. No hernias. No masses palpated. CRP raised at 57 with Hb 5 and MCV 64. Only other abnormality is low albumin at 22



CRP raised means therevis acute inflammation going on. The patient is cachexic and anemic may be due to gastritis due to prolonged use of NSAID. OGD can be done to visualize upper GI and stool antigen test be done for H PYLOR infection. Malignant should be ruled out as well

* GI Bleeding ** Peptic ulcer Needs further investigation and evaluation to conclude and line of treatment.

Thanks Dr Pushkar Bhomia

Imunocompromise HIV patient Severe anemia with Malena So we dealing with upper GI pathology with Low Albumin So ? Lymphoma Adv : endoscopy Biopsy Fungal or viral atypical cause to be rull out

C/ o gasteroparasis with chr constipation

Thanx dr Pushkar ji Bhomia

Upper GI bleed , ? NSAIDs induced . To rule out peptic ulcer , malignancy US abdomen, CT abdomen , tumour markers

Further evaluation is required like colonoscopy Biopsy of descending colon for HPE

Known case of HIV chances of malignancy in Malena 5 gm do enteroscopic biopsy HP possibility of peptic ulcer due to nsaid cd4 normal

Agreed with Dr.Krishnan P. Advised Endoscopic Bx & IHC

Pl rule out iileo colic intussuption

Dilated transverse colon.,?cause.colonoscopy/cect abdomen.

Load more answers

Diseases Related to Discussion