Background: Epidemiology of Non-Variceal Upper Gastrointestinal Bleeding (NVUGIB) such as peptic ulcer bleeding, Mallory-Weiss tear, erosive gastritis/duodenitis, oesophagitis/oesophageal ulcer is well known among general population. However, data is lacking about its trend among Cirrhotic population in literature. No large database study is available to compare prevalence, predictors, and outcomes of NVUGIB among Cirrhotic patients. We [...]

Background: Over the last two decades concerns have been raised about the potential risk of blood transfusion over the benefits. General restrictive red blood cell (RBC) transfusion approach for anemic hospitalized patients (thresh hold of 7 gm %) has been adopted by American hematology society (AHS) in 2012. It is important to recognize that guidelines [...]

Background: UGIB is a common cause of inpatient admissions often associated with morbidity and an overall mortality rate approaching 10%. Since therapy is different, it is important to differentiate between variceal and non-variceal GI bleeding. While both will often need volume resuscitation, proton pump inhibitors (PPI), judicious transfusion and early endoscopy, patients with variceal bleeding [...]

Case Presentation: A 72 year-old male patient with recent deceased donor renal transplant was on combined immune suppression with prednisone, tacrolimus and MMF. He Had multiple comorbidities but no previous history of IBD or autoimmune disease. He presented with normocytic anemia (hemoglobin 6.5 g/dL), weakness, anorexia and diarrhea. He was found to have ulcerated hemorrhoids [...]

Case Presentation: A 76 year-old male with a history of diverticulitis, T2DM, HTN, persistent atrial fibrillation and compensated alcoholic cirrhosis presented for recurrent gastrointestinal bleeding (GIB). He initially presented to an outside hospital six months prior for shortness of breath and found to be anemic requiring 4 units of packed red blood cells (PRBCs). Since [...]

Case Presentation: 57-year-old male patient with past medical history of major depression, essential hypertension and coronary artery disease status post drug-eluting stent placement who presented to the Genitourinary Medical Oncology Clinic due to marked swelling of his left scrotum. Ultrasound showed a hypoechoic solid mass with large left hydrocele. Tumor markers were negative. Computed tomography [...]

Case Presentation: Heyde syndrome is a rare multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome (AVWS). The pathophysiology of AVWS in Heyde syndrome is thought to be due to the increased circulatory shear forces resulting from AS, leading to cleavage of large VWF multimers and loss [...]

Case Presentation: A 59-year old male with a history of hypertension, chronic kidney disease, and Stanford Type A aortic dissection (treated six years prior by open followed by endovascular repair) presented with a four-day history of hematemesis associated with midsternal chest pain. He reported taking a nifedipine tablet, which felt like it was “stuck in [...]

Case Presentation: A 39-year-old Bulgarian man, recently diagnosed with non ischemic cardiomyopathy was transferred to our hospital due to upper gastrointestinal bleeding. The patient reports seven months of intermittent hematemesis that worsened after two significant episodes of vomiting bright red blood. The patient became hemodynamically unstable in spite of aggressive fluid resuscitation and blood transfusion, [...]

Case Presentation: A sixty-six-year-old male with a history of Monoclonal Gammopathy of Undetermined Significance (MGUS), Atrial Fibrillation, and Rheumatic Heart Disease requiring aortic and mitral valvuloplasty, was on warfarin with an INR goal of 3.5-4 due to multiple hypercoagulable factors and recurrent Transient Ischemic Attacks (TIAs) at INR 2.5-3.5. Post prostate cancer radiation, he developed [...]