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The temporal relationship with tirzepatide initiation, absence of infection, and confirmatory histology strongly support drug-induced ischemia in this case, underscoring the importance of clinician awareness of this rare but significant complication in patients presenting with rectal bleeding or abdominal pain while on incretin-based therapy

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The complete coding algorithms used for identifying patient characteristics, clinical diagnoses, medical procedures, pharmaceutical prescriptions, and laboratory parameters are detailed in Supplementary Table 1