The Case of the Lime-green Stool: A Case Report and Review of Occult Blood Testing in the Emergency Department

Introduction: Food dyes mimicking gastrointestinal (GI) hemorrhage have been described in literature. However, reports of food additives causing melanotic stools and falsely positive fecal occult blood tests (FOBT) are uncommon in literature. Case Report: We present a case of a 93-year-old with FOBT...

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Bibliographic Details
Published in:Clinical practice and cases in emergency medicine 2021-08, Vol.5 (3), p.320-324
Main Authors: Salisbury, James, Goodrich, Jennifer, McManus, Nicholas, Offman, Ryan
Format: Article
Language:English
Subjects:
Blood tests
Case Report
Clinical medicine
Color
Creatinine
Emergency medical care
Feces
Food additives
Hemoglobin
Hemorrhage
Medical screening
Medicine
Patients
Ulcers
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Summary:Introduction: Food dyes mimicking gastrointestinal (GI) hemorrhage have been described in literature. However, reports of food additives causing melanotic stools and falsely positive fecal occult blood tests (FOBT) are uncommon in literature. Case Report: We present a case of a 93-year-old with FOBT positive melanotic stool, felt to be falsely positive due to food additives. Conclusion: Evaluation for GI bleeding accounts for 0.3% of yearly visits to the emergency department (ED).1 While FOBT is commonly used, its clinical validity in the ED is not supported by guidelines. We showcase the limitations of the FOBT and review the causes of false positive FOBT.
ISSN:2474-252X
2474-252X
DOI:10.5811/cpcem.2021.4.51656