A 61-year-old male presents to the emergency room with complaints of fatigue,dizziness and bright red blood per rectum(BRBPR)for 2 days.Past medical history was significant for gastroesophageal reflux disease,non-ster...A 61-year-old male presents to the emergency room with complaints of fatigue,dizziness and bright red blood per rectum(BRBPR)for 2 days.Past medical history was significant for gastroesophageal reflux disease,non-steroidal antiinflammatory drug(NSAID)induced ulcer,and end-stage renal disease(GFR<30)status post 2 failed renal grafts.Pertinent medications include pantoprazole and sodium polystyrene sulfonate in sorbitol(Kayexalate 30 g/d orally).On esophagogastroduodenoscopy(EGD)there was a single shallow,flat,non-bleeding gastric ulcer(3mm)in the pre-pyloric region of the stomach with no stigmata of bleeding.A colonoscopy was performed showing evidence of colitis and localized ulcerations in the cecum which were biopsied.Histopathology revealed basophilic,nonpolarizable,rhomboid-like crystals without evidence of necrosis.展开更多
文摘A 61-year-old male presents to the emergency room with complaints of fatigue,dizziness and bright red blood per rectum(BRBPR)for 2 days.Past medical history was significant for gastroesophageal reflux disease,non-steroidal antiinflammatory drug(NSAID)induced ulcer,and end-stage renal disease(GFR<30)status post 2 failed renal grafts.Pertinent medications include pantoprazole and sodium polystyrene sulfonate in sorbitol(Kayexalate 30 g/d orally).On esophagogastroduodenoscopy(EGD)there was a single shallow,flat,non-bleeding gastric ulcer(3mm)in the pre-pyloric region of the stomach with no stigmata of bleeding.A colonoscopy was performed showing evidence of colitis and localized ulcerations in the cecum which were biopsied.Histopathology revealed basophilic,nonpolarizable,rhomboid-like crystals without evidence of necrosis.
