Case Study:
This patient has had 3 visits to our hospital with GI bleed of unknown location : overt obscured GI bleed. At his last visit he was hemodynamically unstable with an HH of 6/18.4. He received 9 units of PRBC's and was deemed stable again with an HH of 9.2/28. During his stay he had an emergency upper endoscopy, colonoscopy, Red tagged cell study, angiography, and capsule endoscopy. They were all negative as far as finding source of bleeding. He has now been dc'ed home to return if bleeding reoccurs and perform a STAT RBC tagged study to identify source of bleeding. Can you reccomend a better way to deal with this case if any? and what would be the tx of choice to avoid that massive amount of transfusions in the future?

Thanks,

Ed