Background: Paracenteses are performed frequently at bedside by hospitalists, intensivists, gastroenterologists and emergency medicine providers. They are considered a core procedure that historically have been performed “blind” with only the use of percussion to determine the presence of fluid. With the rise of ultrasound based procedures the majority of paracenteses are now performed with ultrasound [...]

Case Presentation: A 68-year-old man presented with worsening abdominal distention, lower extremity edema and shortness of breath 8 weeks after undergoing uneventful aortobifemoral bypass graft (AFBG). The patient was cachectic man, who had significant abdominal distention from ascites confirmed with ultrasound, right lung dullness with decreased air entry due to pleural effusions and bilateral lower [...]

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 63-year-old man with lung adenocarcinoma with multiple rib metastases and lytic spinal lesions was receiving palliative radiation treatment when computed tomography (CT) incidentally revealed a fluid collection along the anterior cecum with pneumatosis. Cultures taken during CT-guided abscess drainage were positive for piperacillin-tazobactam-sensitive enterococcus, and the patient was started on antibiotics. His [...]

Case Presentation: A 58-year-old man was brought to the emergency room by his friend for self-neglect. Approximately one year ago, the patient’s mother died. He has been afraid to eat since. Instead, nutritional intake was exclusively liquid and consisted of water, Gatorade and Boost meal supplement. He lost 200 pounds over the past year. Somatic [...]

Case Presentation: An 87-year-old Caucasian male with a history of benign prostatic hyperplasia presented to the hospital with urinary incontinence, abdominal discomfort, and altered mentation. The patient required hospitalization for worsening symptoms. On admission, he was hypotensive (BP of 88/55 mmHg), tachycardiac (143 b/min), respiratory rate of 20 bpm, and temperature of 96.3° F. Pertinent [...]

Case Presentation: A 56 year old caucasian male with extensive sarcoidosis of the lungs, heart, pancreas and liver had a surveillance 6 month CT scan of the chest+abdomen+pelvis to look for disease progression. Incidentally, he was found to have pneumatosis of the hepatic flexure of colon with surrounding pneumoperitoneum in the absence of associated inflammatory [...]

Case Presentation: A 36-year-old woman with Loeys Dietz Syndrome (LDS) presented with complaints of a “gurgling” sensation in her right chest. Her medical history included an aortic root aneurysm repair, aortic valve replacement and pneumothorax treated with chest tube. Physical exam demonstrated pectus excavatum and a rub throughout all right lung fields. Chest X-ray revealed [...]

Case Presentation: 48-year-old female with past medical history of cirrhosis secondary to HBV (on entecavir) and EtOH, decompensated by hepatic encephalopathy and ascites, coronary artery disease s/p stenting to LAD in 2009 presented to the hospital with abdominal pain and distension for a 1-week duration. She stated that the pain radiated to her back and [...]