Cigarette Smoker With GI Bleeding- Let’s Diagnose

A 66-year-old man with a history of atherosclerosis, hemodialysis, and 45+ years of cigarette smoking (one pack a day) presented to the doctor with a sudden onset of lower abdominal pain and cramping, gastrointestinal bleeding, and diarrhea that occurred within the last 24 hours. Laboratory testing confirmed heme-positive stool. Cryptitis with “withering” crypts were visible on histopathologic testing. The patient was not on any medications and had no previous history of gastrointestinal disease.

Which diagnosis is it?

  1. Ischemic colitis
  2. Acute mesenteric ischemia
  3. Diverticulitis
  4. Ulcerative colitis

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