SAQ Library

Case: Paediatric Rectal Bleeding

The concerned parents of a 4-year-old boy present to your urban district emergency department with their son, who has had a 2-day history of abdominal pain and rectal bleeding.

The abdominal pain has been crampy and intermittent. His parents report approximately five episodes of bright red blood per rectum with clots, which appeared to be a large volume of blood. He has not vomited and has been afebrile. There are no known sick contacts and no recent travel.

He saw his GP the previous day after the first episode of bleeding and blood tests at that time showed Hb 119 g/L.

On examination he appears pale but alert and interactive. Observations: Temp 37.5, HR 120 increasing to 140 when standing, BP 102/42, RR 24, SpO2 96% RA, cap refill 4-5 seconds.

Abdominal examination reveals a soft, nondistended abdomen with marked tenderness in the left lower quadrant.