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Rectal Bleeding in a 4-Month-Old Boy

John A. Dutro, MD; Steven A. Santanello, DO; Frances Unger, MD; Charles D. Goodwin, MD
JAMA. 1986;256(16):2239-2240. doi:10.1001/jama.1986.03380160097027.
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Clinical Information  A 4-month-old boy was seen initially with a 24-hour history of painless hematochezia. His parents had noted two episodes of maroon-colored stool that did not appear to be associated with any abdominal distress. No history of hematemesis or diarrhea was obtained. His medical history was unremarkable, with normal growth and development.Physical examination revealed a well-nourished, well-hydrated infant in no apparent distress. Vital signs were normal. The abdomen was soft, with no palpable masses and active bowel sounds. Rectal examination revealed no masses, but bright-red blood was noted on the examining finger. Findings from the remainder of the examination were normal.Laboratory data demonstrated a hemoglobin level of 7.7 g/dL (77 g/L) and a hematocrit of 22.8% (0.22). The white blood cell count was 6600/mm3 (6.6×109/L). An upright roentgenogram of the abdomen was obtained and demonstrated no abnormalities. The abdominal technetium scan is shown in


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