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A 12 yr old male comes with hemetemesis every 2 or 3 day no malaena hemetemesis is about 8 to 10 times in a month he vomits fresh blood about 10 to 20 ml or more all reports normal endoscopy shows nothing done during bleed blood indices normal lft normal liver scan normal x ray chest normal ba meal normal usg abd nad colour doppler usg liver doesnot show portal hypertension or budd chiari pt has haemobilia what should do now angio or tech scan and what else.
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What is the PT, PTTK, Thrombin time, platelet count of the child? If they all are normal, then you should go ahead with an RBC tagged scan to detect the site of bleed. Also, rule out Zollinger Disease.
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