Case Presentation: The patient is a 20-year-old male with no past medical history who presented with a 6 day history of 6/10 constant sharp abdominal pain focused in the right upper quadrant (RUQ). The pain was worsened by eating, and associated with one episode of yellow, non-bloody vomiting. The patient denied any diarrhea, bloody stool, [...]

Case Presentation: A 58 year old man with history of Enterococcus faecalis endocarditis and mechanical aortic valve replacement on oral anticoagulation presented to the emergency department with epigastric and right upper quadrant abdominal pain, melena, hematochezia, and hematemesis of one weeks’ duration. Physical exam revealed jaundice and abdominal tenderness in the right upper quadrant and [...]

Case Presentation: A 19-year-old man with past medical history of recently incompletely treated H. pylori presented to the ED with severe abdominal pain, nausea, and vomiting for 20 days. Vital signs were normal, and physical exam was unremarkable. CT abdomen/pelvis showed diffuse gastric wall thickening with mucosal enhancement and mesenteric, gastrohepatic ligament, and para-aortic adenopathy. [...]

Case Presentation: Heyde syndrome is a rare multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome (AVWS). The pathophysiology of AVWS in Heyde syndrome is thought to be due to the increased circulatory shear forces resulting from AS, leading to cleavage of large VWF multimers and loss [...]

Case Presentation: A 59-year old male with a history of hypertension, chronic kidney disease, and Stanford Type A aortic dissection (treated six years prior by open followed by endovascular repair) presented with a four-day history of hematemesis associated with midsternal chest pain. He reported taking a nifedipine tablet, which felt like it was “stuck in [...]

Case Presentation: 73 year old male veteran with hypertension and stroke presents with progressive anasarca and dyspnea. The patient’s blood albumin level was < 1 g/dL, and his urine protein to creatinine ratio was > 5.5 grams per day, leading to a diagnosis of nephrotic syndrome. Renal biopsy revealed Immunoglobulin Light-Chain (AL) Amyloidosis. He responded [...]

Case Presentation: A 39-year-old Bulgarian man, recently diagnosed with non ischemic cardiomyopathy was transferred to our hospital due to upper gastrointestinal bleeding. The patient reports seven months of intermittent hematemesis that worsened after two significant episodes of vomiting bright red blood. The patient became hemodynamically unstable in spite of aggressive fluid resuscitation and blood transfusion, [...]

Case Presentation: A sixty-six-year-old male with a history of Monoclonal Gammopathy of Undetermined Significance (MGUS), Atrial Fibrillation, and Rheumatic Heart Disease requiring aortic and mitral valvuloplasty, was on warfarin with an INR goal of 3.5-4 due to multiple hypercoagulable factors and recurrent Transient Ischemic Attacks (TIAs) at INR 2.5-3.5. Post prostate cancer radiation, he developed [...]

Case Presentation: A 79-year-old patient with a history of esophageal cancer status post esophagectomy six years prior with neo-esophagus creation and chemotherapy currently in remission, was admitted for upper tract gastrointestinal (GI) bleeding. An esophagogastroduodenoscopy (EGD) demonstrated several non-bleeding gastric ulcers. Given stability and resolution of the bleeding, the patient was discharged home. Later that [...]

Case Presentation: A 76-year-old man with mantle cell lymphoma status post chemotherapy 1 week prior presented to an outside emergency department with generalized weakness. Initial laboratory workup revealed hemoglobin of 8.8 g/dL, platelet count of 3 × 109/L, creatinine 5.55 mg/dL and bicarbonate 7 mmol/L (Table 1). Rectal exam showed brown stool, however fecal occult [...]