Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of recurrent gastrointestinal bleeding in the setting of known or suspected Hereditary Hemorrhagic Telangiectasia (HHT). History is significant for [recurrent epistaxis/iron deficiency anemia/family history of HHT]. Current symptoms include [melena/hematochezia/symptomatic anemia]. Patient reports [number] of prior endoscopic interventions and transfusion requirements of [number] units of PRBCs over the past [timeframe]. No history of recent anticoagulation use.
Clinical Examination Findings
General: Patient appears [well-developed/pale/fatigued]. HEENT: Examination reveals characteristic telangiectasias on the lips, oral mucosa, and tongue. Nasal mucosa inspected for evidence of recent epistaxis. Cardiovascular: Regular rate and rhythm, no murmurs. Abdomen: Soft, non-tender, non-distended, bowel sounds present. Skin: Multiple small, blanching, red-to-purple telangiectasias noted on fingertips and palms.
Treatment Protocol
Plan: 1. Management of iron deficiency anemia with [oral/IV iron supplementation]. 2. Endoscopic evaluation (EGD/Colonoscopy/VCE) to identify and treat bleeding telangiectasias via [argon plasma coagulation/cautery/clipping]. 3. Consider anti-angiogenic therapy (e.g., Bevacizumab) for refractory cases. 4. Monitor hemoglobin and ferritin levels every [interval]. 5. Genetic counseling referral.