He has had no previous hospitalizations for abdominal pain but was diagnosed as having diverticular disease after a barium enema in 1982. Physical examination reveals a slightly overweight, white male, somewhat pale in color. Orthostatic changes are rooted. The abdomen is soft and non-tender with no abdominal masses. Bowel sounds are increased.
Rectal exam reveals bright red blood in the rectal vault.
Diagnostic studies include a chest x-ray and abdominal series that are read as normal. Hemoglobin is 12, hematocrit 31, PT and PTT normal. He is typed and crossed for 6 units of packed red cells. After four hours and a total of 5 units of packed red blood cells, the bleeding stops. Twenty-four hours later, the bleeding resumes with mild hypotension.