Today we learned of a case of severe hametochezia associated with fatigue. The diagnosis turned out to be atypical HUS, which usually presents with diarrhea, renal failure, MAHA, and non-immunologic thrombocytopenia (lovely review: NEJM 2009; 361: 1676). While atypical HUS will rarely be encountered by the typical internist, hematchezia and its many causes will remain staples (pun) in the generalists outpatient and inpatient chief complaint list. Below, we address a few common concerns in the diagnosis and management of hematochezia (lovely review: Nat. Rev. Gastroenterol. Hepatol. 2009; 6: 637).
1. What are the common causes of hematochezia?
2. How do you diagnose and manage inpatient hematochezia?