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A 36-year-old woman presented with dark red rectal bleeding, loose watery stools and a 6 day history of epigastric pain. She had a past history of gestational diabetes but no other past medical or family history. She had been taking ranitidine prescribed by her general practitioner for 3 days and had taken ibruprofen for 6 days for a sore throat a few weeks ago. On admission, her pulse was 110 beats/min and blood pressure was 95/58 mm Hg. She had generalised abdominal tenderness and bright red blood on rectal examination. The results of blood analysis were: white cell count (WCC) 13 × 109/l, haemoglobin (Hb) 13.6 g/dl, platelets 287 × 109/l, urea 5.8 mmol/l, creatinine 60 µmol/l, amylase 33 µ/l, C reactive protein (CRP) 17 mg/l, prothrombin time (PT) 10.6 s, activated partial thromboplastin time (APTT) 21.5 s.