2 weeks ago, I had a patient presenting with an upper GI bleed. Despite aggressive treatment, the patient was still hypotensive and actively bleeding. Unfortunately, the GI fellow was on home call and further than expected from the hospital…
Case: 37-year-old M presenting with obtundation and possible seizure-like activity after a large overdose of sustained-release bupropion (Wellbutrin XL), gabapentin, and other unknown medications. Given the severity of this patient’s…
Case Summary: 22 y/o M no pmh p/w painless jaundice x 5 days in the setting of recent febrile illness 1 week prior and taking Tylenol 1g q6h for several days. Physical exam was positive for jaundice, otherwise normal. Notable lab findings i…
Inspired by what appears to have been a very interesting day in the Peds ED, lets review a rare but interesting pediatric entity: PYLORIC STENOSIS Background: MC in Males (5:1) & firstborn children (30%) Usually begin between 3-6 wks of…
“The HgB has dropped, have you checked a guaic?” How many times have you checked a FOBT in your workup for anemia? Let’s take a look at what FOBT is supposed to be used for. FOBT is a visual stool assay in which heme in th…
A patient is sent from nursing home at 10pm for a non-functioning PEG tube. He has a prior history of stroke with L sided weakness and is now bedbound at baseline. He has stable vitals, no abdominal tenderness, and is otherwise well appeari…
This is a review of specific pediatric entities that may cause abdominal pain, bloody diarrhea, or vomiting. The following lists are not comprehensive and emergency physicians should consider a broad differential based on symptoms and prese…
Clinical Scenario: A 2-year-old female with no significant past medical history presents with vomiting and abdominal pain for 1 day. Among other entities in your differential diagnosis you are considering intussusception, however it is lowe…
Clinical Scenario: A 68-year-old man with a past medical history of diabetes mellitus, hypertension, and recent admission for pneumonia presents with fever and diarrhea for 5 days. The patient has had multiple watery stools per day. Associa…
Article Citation: Palamidessi N, Sinert R, Falzon L, Zehtabchi S. Nasogastric aspiration and lavage in emergency department patients with hematochezia or melena without hematemesis. Acad Emerg Med. 2010 Feb;17(2):126-32. PMID: 20370741 What…
