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 [...]

Case Presentation: Ms. S is a 64 year old woman recently diagnosed with multiple myeloma following a hip fracture and repair, who was transferred from an outside hospital for hematochezia. She was admitted to the outside hospital from a skilled nursing facility for presumed post-operative ileus complicated by nausea and vomiting. During that stay, she [...]

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: An 80-year-old female with a past medical history of atrial fibrillation on daily aspirin, previously managed with Eliquis but discontinued due to multiple GI bleeds of unknown origin, and unexplained leukocytosis up to 61.67K, transferred to an academic hospital from a community hospital for two episodes of hematochezia and symptomatic anemia with a [...]

Case Presentation: A 76-year-old white woman with a past medical history of RA, being treated with MTX, sarilumab, and folic acid supplementation, presented to the hospital for worsening pain and lethargy. Physical exam displayed dry mucous membranes, ulcerations throughout the oropharynx, and purple digits from distal interphalangeal joints to the fingernails bilaterally. Additionally, she was [...]

Case Presentation: Our patient is a 66-year-old female who was admitted for shortness of breath and generalized weakness. She was severely anemic with hemoglobin of 6.5. Her EGD did not show any obvious evidence of bleeding. Colonoscopy in the past showed a large inflammatory mass consistent with ischemic colitis. Follow-up colonoscopy showed completely healed mucosa. [...]

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: Acute esophageal necrosis (AEN) is a rare condition which presents as acute-onset gastrointestinal bleeding. AEN is associated with vasculitis, coronary artery disease, malignancy, and other conditions which impair maintenance of the esophageal protective barrier. Complications of AEN include esophageal rupture, perforation, stricture formation, and mediastinitis. A 64-year-old Caucasian female with an extensive past [...]

Case Presentation: A 80-year-old female with a past medical history of diabetes mellitus, hypertension and coronary artery disease status post stenting 4 years ago presented with coffee ground emesis, epigastric pain, dysphagia and melena. On examination, her vital signs showed a heart rate of 92 beats/minute and blood pressure of 89/55 mm Hg. Her abdomen [...]

Case Presentation: A 52-year-old man originally from West Africa presented with two episodes of hematemesis over one day and with intermittent diffuse abdominal pain and fatigue over one week. He is a known HIV/AIDS patient with poor compliance along with a history of chronic Hepatitis B cirrhosis and moderate-sized varices, H. pylori with non-compliance with [...]