Case 7-1976

Presentation of CaseA 38-year-old woman was admitted to the hospital because of bleeding per rectum.There was a long history of alcohol abuse and chronic liver disease, with slight chronic anemia that was treated with iron and folic acid. Mild, variable hypertension was found nine years before entry. Two years before admission the patient began to have grand-mal seizures, which were attributed to alcohol withdrawal and were treated with diphenylhydantoin sodium and phenobarbital. During the two years before entry she noticed the occasional appearance of bright-red blood on the surface of her stools. Four days before admission she observed . . .