Background: Patients admitted for nonsurgical management of small bowel obstruction (SBO) often receive intravenous (IV) opioids for pain relief. However, given the opioid crisis and the potential for opioids to hinder recovery and contribute to ileus, exploring alternative analgesics is crucial. This randomized controlled trial (RCT) evaluates the efficacy of IV acetaminophen for pain management [...]

Background: Patients hospitalized for vaso-occlusive crisis (VOC) frequently report dissatisfaction with pain management, which is exacerbated by variability in treatment approaches across healthcare providers. Negative provider perceptions, stigmatized language in the electronic medical record, and misperceptions of appropriate pain management are associated with undertreatment of pain, prolonged hospitalizations, and worse disease-specific outcomes. Effective management of [...]

Background: Patients with sickle cell disease (SCD) often face frequent emergency department (ED) visits and hospital readmissions, primarily driven by challenges in pain management, stigma, and system-level barriers. Existing interventions at the CU Division of Hospital Medicine, such as cohorting patients with specific teams, multidisciplinary care conferences, and implementing care plans for high-utilizer patients, have [...]

Case Presentation: A 67-year-old man with a history of chronic back pain from a motor vehicle accident (MVA) 20 years ago presented to his primary care provider for an annual visit in December 2023. He complained of persistent back pain. Lab work was unremarkable and an x-ray showed degenerative lumbar spine changes. The patient was [...]

Case Presentation: A 32-year-old woman presented with progressively worsening abdominal distention for weeks associated with abdominal pain, postprandial nausea and emesis. The physical exam was notable for generalized tenderness and fluid wave. Lab work revealed proteinuria, acute kidney injury, normocytic anemia, and leukocytosis. She had undergone a diagnostic paracentesis at an outside hospital that had [...]

Case Presentation: A 50-year-old female with history of seropositive rheumatoid arthritis, peptic ulcer disease, and chronic idiopathic pancreatitis status post Whipple procedure presented with one-week history of nausea, vomiting, and diarrhea. Her symptoms began prior to a cruise vacation, though she denied any other recent travel or sick contacts. The patient endorsed similar episodes up [...]

Case Presentation: This case highlights a 31-year-old female who presented with severe post-prandial abdominal pain and night sweats who was identified to have marked thrombocytosis (2.5million) with only a mild leukocytosis(20K). The patient was admitted to the hospital for urgent evaluation given the risk of untreated extreme thrombocytosis. A bone marrow biopsy was conducted which [...]

Case Presentation: A 62-year-old woman with hypertension, carpal tunnel syndrome, and a year-long history of complex regional pain syndrome (CRPS) presented with chronic, severe right arm pain along with swelling and erythema. One year before this presentation, she had experienced right-hand numbness and tingling, leading to a carpal tunnel syndrome diagnosis and subsequent release surgery. [...]

Case Presentation: A 31-year-old healthy man presented with several days of chest and back pain associated with shortness of breath, subjective fever, headache, and photophobia. The patient worked in construction and complained of a recent itchy, vesicular rash to his forearm. Review of systems was otherwise negative for recent procedures or surgeries, IV drug use, [...]

Case Presentation: A 69-year-old male with a significant past medical history of rheumatoid arthritis on methotrexate presented with acute-on-chronic lumbar pain. Initial imaging revealed an L3 compression fracture, with findings suggestive of discitis or osteomyelitis at L2-L3. MRI confirmed discitis/osteomyelitis, along with an epidural abscess and bilateral psoas abscesses. Further imaging also revealed cavitary pulmonary [...]