#MedicalCase

Occasional fresh blood in infant (General Medicine)

Dr. Albana Greca., MBBS, MMEDSC

 

Medical Case Details:

Hello my dear colleagues,

I have a difficult case to share with you. My patient 2 months old, since 2 weeks has been experiencing blood when changing diapers first thing in the morning. I've attached a photo.

The only connection is he has been crying heavily a day before, screaming.

What to do next? Is there a need to consult with urologist? Or just watchful waiting?

No other signs. Everything is ok, growth ok, breastfeeding, genitalia clear, no inflammation.

Thank you in advance.

 


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    Discussions


    Dr. Prasanna Lakshmi

    Blood in stools?or urine?if stools require urgent ultrasound to rule out malrotation of gut with volvulous,needs testing for bleeding diathesis,vit k injection,even if ultrasound is normal ct angio for abnormal blood vessels.if from urine also requires ultrasound to rule out wilms tumour.

    26.Dec, 10:16am

    Dr. Albana Greca

    Thank you Dr.Prasana Lakshmi,

    Ultrasound revealed nothing, everything is ok, except for crystals in bladder and kidney. The urine analysis was negative for blood including microscopic examination.

    The supposed coloring is from urine and not stool, early in morning only, Now, since one week, everything is normal, the diapers are clean, just normal urine.

    Do you think we should go for normal ct-angio for abnormal vessels after evaluating this scenario?
    Thank you.

    28.Dec, 12:04am

    Dr. Prasanna Lakshmi

    Helo,crystals of size mam?any calcium like deposition.if so idiopathic familial hypercalciuria is a possibility.please check for u.calcium creat ratio.if it is normal.wait and watch.and please rule out bleeding diathesis with pt,ptt,inr

    28.Dec, 12:07am

    Dr. Albana Greca

    Hello back Dr.Prasanna,

    Thank you very much for your input. I too was thinking about running PT, PTT, and INR although his pediatrician did not confirm so far. Crystals were tiny and not measurable. They were defined as urate.

    Thank you very much.

    28.Dec, 12:28am

    Dr. Prasanna Lakshmi

    Glad am helpful.

    28.Dec, 12:29am

    Dr. Jayvirsinh Indrasinh Chauhan
    Homeopathic Physician

    You can give homoeopathic medicine Sarsaparilla 200 twice a day for 3 days... see if it helps..
    It can be better prescribed with detailed case.


    31.Dec, 12:15pm

    Dr. Amiya Kumar Chattopadhyay
    Cardiologist

    Urate crystals( combination of calcium and urate) also called brik stain crstal.
    First few weeks baby can pass this crystals and diaper become red stain if baby is dehydrated or slightly dry where baby is breast feed and mom's milk supply less is than adequate. Not to worry.

    31.Dec, 04:08pm

    Dr. Albana Greca

    Thank you very much for your valuable and reassuring input Dr.Dr. Jayvirsinh Indrasinh Chauhan and Dr. Amiya Kumar Chattopadhyay.

    03.Jan, 02:52am



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