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Unusual cause of lower gastrointestinal bleed and abdominal pain
  1. Varun Kesar1,
  2. Komal Lakhani2,
  3. Arun Swaminath2
  1. 1 Gastroenterology, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
  2. 2 Gastroenterology, Lenox Hill Hospital, New York, New York, USA
  1. Correspondence to Dr Varun Kesar, Gastroenterology, Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, USA; varundkl8{at}

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A young patient with a history of systemic lupus erythematosus (SLE) complicated by lupus nephritis presented to the emergency department with vomiting, diarrhoea and diffuse abdominal pain for 7 days. The diarrhoea was watery and yellow in colour with occasional mucus and blood. The patient had a similar presentation in the past, but no specific diagnosis had been made on prior admissions. Patient denied fever, chills, rashes, night sweats or joint pain. On physical examination, vitals were within normal limits. The examination was pertinent for a soft abdomen with diffuse tenderness to palpation, without peritoneal signs. CT of the abdomen and pelvis revealed thickening of small bowel and severe colitis with relative rectal sparing and moderate terminal ileitis (figure 1). Laboratory parameters were significant for anaemia with haemoglobin of 98 g/L, leucocytosis of 14 500 …

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  • Contributors VK is the corresponding author and was involved in drafting the manuscript. KL is the second author who helped in the acquisition of images and correcting the manuscript. AS is the senior author who provided supervision and made necessary corrections in the manuscript.

  • Funding This research has received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests No, there are no competing interests for any author.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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