Case Presentation: Pyroglutamic acid (5-oxoproline) is a rare cause of metabolic acidosis most often associated with sub-acute or chronic acetaminophen intake in the presence of unique risk factors. Discussion: A 25-year old female with Crohn’s disease presented with one month of worsening abdominal pain, diarrhea, and anorexia with reported 20 kg weight loss. She developed [...]

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 [...]

Case Presentation: A 27-year-old male presented to the hospital after developing jaundice with elevated transaminases on routine labs. Patient described preceding two-week febrile illness characterized by general malaise, chills, and myalgias. He received two courses of antibiotics without resolution of symptoms. To manage fever, he consumed 7 grams/day of acetaminophen consecutively for 5 days. His [...]