Case Presentation: A 49-year-old male with primary sclerosing cholangitis and newly diagnosed locally advanced cholangiocarcinoma was initiated on 5-Fluorouracil (FU) based chemotherapy (FOLFOX) as an outpatient (Figure 1). Within one day of receiving FOLFOX, the patient presented to the ED with acute, intermittent chest pain radiating to his left arm and shortness of breath. Vital [...]

Background: Cholangiocarcinoma is an uncommon cancer with a very bad prognosis despite advances made in treatment. Location intrahepatic versus extrahepatic – determines surgical options. In our study, we examined variations in outcomes between patients admitted to the hospital with intrahepatic versus extrahepatic disease. Methods: Data from the National Inpatient Sample (NIS) which is part of [...]

Background: Introduction: Colorectal cancer is the 4th most common cancer in the United States. It is the second most common cause of death in the united states. Despite universal advocacy for screening colonoscopies and early diagnosis, disparities in screening and diagnosis of colorectal cancer exist which affects outcomes. In this analysis, we determine racial disparities [...]

Background: Acute kidney injury (AKI) is a common complication of renal cell carcinoma or its treatment. It is unclear whether AKI, compared to inpatients with similar clinical and hospital-level characteristics without AKI, is associated with worse clinical outcomes and higher costs. To address this void, our study aimed to evaluate how an AKI diagnosis affects [...]

Case Presentation: A 71-year-old man presented with pus from the umbilicus. Past medical history was pertinent for persistent urinary tract infection for a month, complicated by feculent urine and pneumaturia despite two rounds of antibiotics, and 20-lb weight loss. He was found to have purulent drainage from the umbilicus. Lower abdomen was tender without rebound [...]

Case Presentation: A 66-year-old female with newly diagnosed diabetes mellitus type 1 (DMT1) and hypertension was evaluated for severe hypokalemia on routine labs. Associated symptoms included generalized fatigue, muscle cramps, bilateral lower extremity edema. Physical exam was remarkable for moon face, bibasilar crackles, and lower extremity edema. Initial workup showed sodium of 151 mEq/L, potassium [...]

Case Presentation: A 59-year-old female with a history of Asthma, COPD and tobacco use, unknown to have malignancy, presented to the emergency department complaining of dyspnea, cough and back pain. She had tachycardia, tachypnea and oxygen saturation was 91% on 2 liters oxygen. Physical exam was significant for bilateral wheezing.Initial workup showed a high white [...]

Case Presentation: A 90-year-old man with a history of left upper lobe pulmonary nodule on prior imaging presented with dark tarry stools, fatigue and syncope. He had not had an EGD or colonoscopy done in about 10 yrs. Five months prior to this presentation, a 2.4 cm left upper lobe pulmonary nodule suspicious for neoplasm [...]

Case Presentation: A 64-year-old obese male with history of atrial fibrillation, congestive heart failure (CHF) and alcohol use presented with subacute worsening of lower extremity edema, fatigue, and exercise tolerance. Five months prior to presentation, he was admitted to an outside hospital with newly diagnosed atrial fibrillation and CHF. At that time an echocardiogram showed [...]

Case Presentation: A 45 year-old Cambodian female with no past medical history presented to the clinic with a mild cough. Her medical history was notable for never smoking, occasional alcohol use, and no recreational drug use. She had no known occupational exposures and no family history of malignancy. Initial treatment for gastroesophageal reflux disease and [...]