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A 72-year-old male presents to the hospital with a two-day history of bright-red blood per rectum. He reports no weight loss, fever, chills, nausea, vomiting, or diarrhea. He has a history of hypertension, diabetes, hyperlipidemia, and chronic constipation. Temperature is 37.1C (98.8F), pulse is 98 beats/minute, respiratory rate is 20 breaths/minute, and blood pressure is 132/94 mmHg. Abdominal examination reveals slight tenderness in the left-lower quadrant, without guarding or rebound. The remainder of the physical examination is normal. Which of the following is the most likely diagnosis for this patient? A Colon cancer B Diverticulosis C Gastritis D Inflammatory bowel disease E Perforated colon

Answer :

Final answer:

The most likely diagnosis for the patient's symptoms is Diverticulosis, given his age, chronic constipation, absence of other serious illness symptoms, and the fact that he has slight tenderness in the left lower quadrant of his abdomen.

Explanation:

The most likely diagnosis for this 72-year-old patient is B. Diverticulosis. Diverticulosis is a condition characterized by small pouches, called diverticula, that form along the lining of the colon, especially the sigmoid colon. These diverticula can occasionally become irritated or inflamed, leading to a condition called diverticulitis, which often presents with left lower quadrant abdominal pain and sometimes rectal bleeding. Given this patient's age, chronic constipation, and the absence of other symptoms such as weight loss, fever or vomiting, diverticulosis is a more likely explanation for his rectal bleeding than the other conditions.

While colon cancer (Option A) can sometimes cause rectal bleeding, this patient's lack of other common colon cancer symptoms such as weight loss and changes in bowel habits make it less likely. Gastritis (Option C) and inflammatory bowel disease (Option D) are less likely considering the location of the patient's abdominal discomfort and the absence of other typical symptoms. A perforated colon (Option E) would likely present with severe abdominal pain and signs of systemic illness, which this patient does not have.

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