Background: Acute pancreatitis (AP) is one of the most common causes of hospitalization in the United States. Intravenous hydration with normal saline (NS) is the most commonly used fluid for resuscitation. Recent studies have shown better outcomes with the use of more pH balanced fluid-like ringer’s lactate and Plasmalyte (PL). We conducted a retrospective cohort [...]

Case Presentation: A 20-year-old male with past history of asthma presented initially with bloody diarrhea and subjective fever of one day’s duration. Upon evaluation vital signs revealed temperature of 103 F, and tachycardia. On physical examination there was generalized abdominal tenderness with normal bowel sounds. Thrombocytopenia was present with platelet count of 46 k/ul. Antibiotics [...]

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: A 65-year-old man with a past medical history of gout and chronic pancreatitis complicated by pseudocyst presented with bilateral lower leg swelling, erythema, and pain for few weeks. The rash was also associated with bilateral lower extremity nodules that would spontaneously open and discharge white material. He was seen and treated in the [...]

Case Presentation: This is a case of a 22 year old female with history of systemic lupus erythematosus (SLE) complicated by lupus nephritis class III/IV, immune thrombocytopenia, coombs positive anemia, discoid lupus & seizures, who presented to the ED with a 2 week history of feeling “unwell” and a 1 week history of epigastric pain [...]

Case Presentation: A 45 year-old gentleman with a history of recurrent alcoholic pancreatitis complicated by pancreatic pseudocyst presented to the hospital after three episodes of hematochezia. Ten days prior, he had undergone endoscopic transgastric metal stent placement between his pseudocyst and stomach, followed 6 days later by pseudocyst drainage with necrosectomy. After 3 days, he [...]

Case Presentation: A 37 year-old woman with a past medical history of depression and chronic knee pain presented with complaints of two day duration non-radiating 8/10 epigastric and lower abdominal pain associated with nausea and vomiting. Vitals sings were normal. Abdomen was soft, non-distended with generalized tenderness, but without masses, rebound, or guarding. Lipase was [...]

Case Presentation: A 35 year old African American woman with a past medical history of alcohol and tobacco abuse and acute pancreatitis presented to the hospital with a progressive dyspnea and nonproductive cough for one month not responding to outpatient antibiotics. Six months prior to presentation, she was hospitalized for acute pancreatitis that was attributed [...]

Case Presentation: The case begins with a 71-year-old female named MB. She initially presented with two weeks of worsening back pain, falls, and renal insufficiency. The pain itself radiated from her mid epigastrium to her back. The patient had a past medical history of COPD, paroxysmal atrial fibrillation, and heart failure with reduced ejection fraction. [...]

Case Presentation: A 65-year-old male presented to the emergency department with a 5-week history of epigastric pain, nausea, constipation and weight loss. Past medical history was significant for combined liver and kidney transplant 3 years prior due to hepatitis C cirrhosis and hepatorenal syndrome. Chronic immunosuppression consisted of mycophenolate mofetil, tacrolimus and prednisone. Laboratory studies [...]