Case Presentation: An 80 year-old female presented to the emergency room with shortness of breath and melena. She was afebrile, with blood pressure of 121/70 and heart rate 93. Labs showed hemoglobin of 5.2 g/dL with normal INR and platelet count. She underwent an upper endoscopy revealing a 2 mm clean-based duodenal ulcer. As this […]

Case Presentation: We present a 68 year-old man, with a history of benign prostatic hypertrophy, who presented with several months of progressive personality changes and mild gait changes. His wife noticed he had become more introverted, and his gait had become more ataxic with prolonged ambulation. He also started having subtle memory problems. On physical, […]

Case Presentation: 56-year-old man with past medical history of abdominal aortic aneurysm surgery was brought to the Emergency Room for change in mental status and having bloody vomitus and melenic stool. On admission, abdominal exam was unremarkable, blood pressure was 110/77 mmHg, heart rate 103/min, Temperature 99.8 °C, Respiratory rate 20 per minute, hemoglobin 11.1 […]

Case Presentation: A 64 year old female with a pmh of Klinefelter’s syndrome (XXY) s/p gender reassignment surgery, hypothyroidism, asthma, obesity, hyperlipidemia and diverticulosis presented with 6 days of worsening lower abdominal pain and discomfort with diarrhea, mucus and bloody stools along with low-grade fevers, nausea, fatigue, weakness and lower abdominal cramping exacerbated by bowel […]

Case Presentation: Pancreaticopleural fistula is a rare and serious complication of acute and chronic pancreatitis. This phenomenon develops due to a leak from an incompletely formed or disrupted pseudocyst, though it can also result from direct pancreatic duct leak. Although few case reports identify pancreaticopleural fistula causing recurrent pleural effusion and empyema, we describe the […]

Case Presentation: A 45-years-old African American male with a past medical history of seizure disorder, chronic alcohol abuse, and cervical spine injury, presented to hospital after a witnessed tonic-clonic seizure episode that resolved spontaneously. Initial evaluation revealed hypotension (90/57mmHg), tachycardia (145), tachypnea (36), temperature of 39.1 degrees celsius, leukocytosis (24.2×10^3/microliter) with bandemia, and lactate of […]

Case Presentation: A 54 year-old woman with history of pulmonary embolism and deep vein thrombosis (with prior placement of inferior vena cava (IVC) filter on apixaban) presents with recurrence of hematemesis and dark stool. This was her third hospitalization with GI bleed requiring transfusion in the last few weeks. Her prior work up included multiple […]

Case Presentation: An 84-year-old female with history of pediatric paralytic polio, heart failure with preserved EF, atrial fibrillation, coronary artery disease presented with progressive shortness of breath (SOB). Four months prior, she had presented to the emergency department with similar SOB and generalized weakness. At that time EKG, CT angiography chest and transthoracic echocardiogram were […]