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WASHINGTON, D.C. – Second-year gastroenterology fellow Dr. I. Scopalot was flabbergasted to hear about an unusual case of guaiac-positive stool found in the emergency department at 3 AM on a Saturday morning.

gastroenterologist“You know, I was taking home call and covering 3 hospitals for a full weekend, but I immediately took notice when the ED called me to tell me that a hemodynamically stable patient with normal hematocrit showed up complaining of abdominal pain that has been present for the past 3 years and is relieved by turkey sandwiches and a mysterious medication that starts with the letter D,” explained Scopalot.  “I’m not sure why they decided to send a guaiac on the stool – I’m told it wasn’t dark or tarry or otherwise abnormal looking at all – but boy, am I glad they did!”

Internal medicine resident, Dr. Dewey Overtest, who is currently rotating in her first week of ER rotation stated, “I believe in being as thorough as possible with all differential diagnoses.  In this case, I wasn’t necessarily looking to rule out GI bleed.  But the patient pooped while he was here in the ER, so we had to send the sample.  I’m sure glad we discovered what we did.  I was about to send a workup for porphyria and consult Gen Surg for an ex lap.”

Others withing the GI department eagerly await the findings.  According to Chief of Gastroenterology, Dr. Perry Rectaltube, “We cannot wait to find out what the cause of this patient’s symptoms may be.  Positive guaiac with formed brown stool in a stable patient?? It must be something truly mind-blowing.”

As of this writing, the patient is ordered for a bowel prep for potential EGD and colonoscopy, but refuses to be NPO as he remains “too hungry” and insists on several more cups of chocolate pudding, plus some more of that medicine, as he puts it, “You know, the one that rhymes with Schmilaudid.”

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