A 4 year old previously healthy girl presents to the E.R. with a 24-hour history of rectal bleeding & dizziness. She has no other GIT symptoms.
On examination she appears pale. Her heart rate is 140 beats/min, she has a 20 mmHg postural drop in systolic blood pressure. her abdomen is not distended and not tender, and fresh blood and clots are in the rectal vault on rectal examination.
What is your clinical diagnosis?
a) juvenile rectal polyp.
b) Anal fissure.
c) Bleeding Meckel's diverticulum.
d) Hemorrhoids.
e) Intussusception.
What is the appropriate diagnostic study for her condition?
a) Colonoscopy.
b) Laparoscopy.
c) Technetium scan.
d) UGI contrast study with small bowel follow through.
e) Barium enema.
