Background: Hepatic artery pseudoaneurysm (HAP) is a rare entity, potentially life threatening and associated with high mortality. The aim of this study was to evaluate Mayo Clinic enterprise’s clinical experience with HAP occurrence, clinical features and outcome in the last 20 years, and to compare our results with what the literature. Methods: This retrospective analysis [...]

Case Presentation: A 56-year-old man presented with one day of high fevers to 104°F, myalgias, and non-productive cough. His past medical history is significant for polycystic liver disease leading to liver transplant, and metastatic neuroendocrine tumor managed with intravenous somatostatin. Two weeks prior to admission, he began a taper of his immunosuppressive medication. On the [...]

Background: Successful hospitalist co-management programs address provider knowledge base as well as ongoing faculty skill development and education (1). With a growing liver transplant program, our institution has seen increased patient volume on the hospitalist liver service. Hospitalists and hepatologists co-manage this expanding population of high acuity patients with complex pathologies. In the past year, [...]

Case Presentation: A 29-year-old otherwise healthy man presented to the emergency room with five weeks of progressively worsening pruritus and fatigue. The patient denied recent ingestion of herbal supplements, and reported lifetime abstinence from alcohol use. Physical exam revealed jaundice and scleral icterus. No ascites or hepatomegaly were noted on initial exam. Admission labs revealed [...]

Case Presentation: A 61-year-old female with a history of non-alcoholic steatohepatitis (NASH) cirrhosis complicated by hepatocellular carcinoma (HCC), who underwent a liver transplant 2 months prior, presented to an outpatient clinic complaining of several days of fatigue, headache, nausea, vomiting, abdominal pain and confusion. Her headaches were new since the transplant. She denied any fevers, [...]

Case Presentation: The patient is a 58-year-old male with a past medical history of end-stage liver cirrhosis status post-liver transplantation in 1991 who was on tacrolimus (TAC) 1 mg twice a day. He was admitted for altered mental status, fever and respiratory distress. He was found to have bilateral pneumonia treated as community-acquired pneumonia. The [...]

Case Presentation: A 53-year-old woman with a history of metabolic syndrome and necrotizing pancreatitis presented with new onset ascites. Her story began nine months earlier, when she developed abdominal pain. CT at that time revealed pancreatitis and cholelithiasis without biliary dilation. Lab values were notable for: lipase 55000, total bilirubin (TBIL) 5.3, AST 660, ALT [...]

Case Presentation: A 50-year-old woman presented with two weeks of progressively worsening abdominal pain and distention. The abdominal pain was accompanied by yellowing of her eyes and periods of confusion. She reported consuming 4 shots of vodka daily for greater than 10 years. Vital signs were normal. The patient was grossly jaundiced and exhibited scleral [...]

Case Presentation: A 59-year-old Caucasian male eight months post liver transplant on Tacrolimus and Prednisone and one month post COVID-19 infection presented to our hospital with progressive weakness. Ten days prior to presentation he noted paresthesias of bilateral upper and lower extremities. This progressed to distal 4/5 weakness in all extremities, dysphagia, dysarthria, severe lower [...]

Case Presentation: A 65-year-old male presented to the emergency department with a 5-week history of epigastric pain, nausea, constipation and weight loss. Past medical history was significant for combined liver and kidney transplant 3 years prior due to hepatitis C cirrhosis and hepatorenal syndrome. Chronic immunosuppression consisted of mycophenolate mofetil, tacrolimus and prednisone. Laboratory studies [...]