Background: Endoscopies are commonly performed in the inpatient setting, and successful completion frequently requires close coordination among nurses, hospitalists, gastroenterologists, and anesthesiologists. Given the complexity of this multidisciplinary involvement, as well as variability in patient factors like clinical stability and presentation, endoscopies are prone to delays. These delays may cause frustration amongst care providers and [...]

Background: Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some suggesting otherwise. The purpose of this study is to evaluate if there is any mortality benefit of doing early endoscopy [...]

Background: Lost or improperly labeled specimens may be medically detrimental to patients and have legal implications for the medical professionals and healthcare facility involved. Endoscopy is an especially high-risk location for specimen errors given the large number of biopsies obtained and the high volume of patients served daily by the same team. A 61-year-old male [...]

Case Presentation: A 63 year old male with no past medical history was admitted with five months of bilateral upper and lower extremity weakness as well as a pruritic, erythematous rash on his face, arms, and back. This was followed by progressive dysphagia. Initial workup, including a pectoralis muscle biopsy showing necrotizing myopathy, and MRI [...]

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 69 year old female with history of gallbladder cancer status post cholecystectomy/hepatic wedge resection with roux-en-y choledochojejunostomy and chemoradiation presents with recurrent abdominal pain and fevers of 102oF. She reports 2 prior episodes of bacteremia with no identified source. She was discharged 4 days ago after treatment for cholangitis with cefuroxime and [...]

Case Presentation: This patient is a 34 year old female presenting to the ED complaining of progressive weakness,SOB, bloody vomitus, and tarry stool. She had PMH significant for established diagnosis of Bean Syndrome. On presentation she was normotensive, 113/72mmHg but tachycardic 102. Labs revealed acute microcytic anemia H/H 6.7/23.6 MVC 70.9 prior to transfusion. She [...]

Case Presentation: A 54-year-old Japanese man presented to his primary care physician with a 3-month history of epigastric pain, fever, and unintentional weight loss. Upper endoscopy showed only a gastric polyp. Abdominal computed tomography showed small intestinal dilatation accompanied by adhesion to the sigmoid colon, and perianal abscess. Crohn’s disease was suspected and he was [...]

Case Presentation: A 60-year-old African woman presented to the emergency department with three days of abdominal pain, nausea, and vomiting. She had recently returned from a ten-month trip through rural Ethiopia where she consumed unpasteurized milk and well water with exposure to goats, cats, and livestock. Her medical history was otherwise unremarkable. On exam, she [...]

Case Presentation: A 45-year-old Vietnamese female with history of H. pylori who presented with worsening nausea, vomiting, epigastric abdominal pain and early satiety. Patient reported her epigastric pain had been intermittent for the past six months but had acutely worsen in the last two weeks. There were no initial inciting events that triggered these symptoms. [...]