Case Presentation: 47 year old female with a past medical history of hypertension presented to the emergency room with two days of right upper quadrant pain and a fever to 102F. For several months prior, she complained of bloating, intermittent diarrhea and diffuse abdominal pain that now localized. Her social history was positive for recent [...]

Case Presentation: A 60-year-old male patient who presented with hemoptysis 1-year prior, was found to have sub-centimeter lung nodules and multiple liver lesions on CT chest. The largest hepatic lesion on abdominal MRI was 3.2 x 1.4cm. He declined liver biopsy and presented a year later with abdominal distension, early satiety and unintentional weight loss [...]

Case Presentation: A 73-year-old man with hypertension, atrial fibrillation, coronary artery disease, heart failure, end stage renal disease on hemodialysis, and hypothyroidism presented with 3 weeks of nausea, vomiting, and inability to tolerate food. He had no fevers, abdominal pain, or diarrhea; symptoms did not improve with dialysis. Vitals were normal, abdominal exam was unremarkable, [...]

Case Presentation: A 51 year old female recently diagnosed with metastatic goblet cell carcinoid mixed adenocarcinoma of the appendix with metastasis to the peritoneum, mesentery, small and large bowel status post ileo-cecectomy and ileostomy presented with acute onset anxiety and mania. Patient presented with a two-day history of decreased sleep, flight of ideas and increased [...]

Case Presentation: A 29-year-old man was brought to our emergency department with a new-onset witnessed seizure. He was recently prescribed oral omeprazole for heartburn. He had no known medical conditions but had a family history of MEN1 in his father and paternal uncle. Initial labs showed hypercalcemia, with elevated PTH. MRI brain showed a sub-centimeter [...]

Case Presentation: A 64-year-old female with past medical history of seizures, breast cancer s/p bilateral mastectomy, hypothyroidism, anxiety and agoraphobia on Xanax, tobacco abuse presents to ED after husband found her unresponsive, with agonal breathing, slurred speech, and oral secretions. Last admission in 2019 was significant for Xanax and Benadryl overdose. On admission, vitals were [...]

Case Presentation: A 71-year-old female was transferred from an outside hospital where she was being managed for an AKI following an episode of profuse vomiting and diarrhea. She reported a nine-year history of similar episodes and had received a diagnosis of cyclical vomiting syndrome in the past. She also endorsed 30 lb weight-loss over the [...]

Case Presentation: Insulinoma is a rare tumor that originates in the beta cells of the pancreas with an incidence of 1-4 cases/million persons/year. Less than 10% of insulinomas are malignant and represent a treatment challenge despite the development of new therapeutic approaches in the last decade. A 28 year old female with no past medical [...]

Case Presentation: A 48-year-old female with no significant medical history presented to an outside hospital with epigastric pain of 3 weeks duration. The pain was constant and severe, associated with nausea, vomiting and a 20 lb. weight loss. Serum lipase was elevated at 1135 U/L (nl 8-78). An Abd US revealed multiple hepatic lesions without [...]

Case Presentation: 63-year-old woman with 80-pack year smoking history presented with right flank pain for two days and weight loss of 35lbs in 6 months. Chest X-ray as a part of the workup was found to have a mass like opacity in left lung. Subsequent CT scan of chest and abdomen/pelvis showed a left upper [...]