Case Presentation: A 49-year-old male with primary sclerosing cholangitis and newly diagnosed locally advanced cholangiocarcinoma was initiated on 5-Fluorouracil (FU) based chemotherapy (FOLFOX) as an outpatient (Figure 1). Within one day of receiving FOLFOX, the patient presented to the ED with acute, intermittent chest pain radiating to his left arm and shortness of breath. Vital [...]

Background: Cholangiocarcinoma is an uncommon cancer with a very bad prognosis despite advances made in treatment. Location intrahepatic versus extrahepatic – determines surgical options. In our study, we examined variations in outcomes between patients admitted to the hospital with intrahepatic versus extrahepatic disease. Methods: Data from the National Inpatient Sample (NIS) which is part of [...]

Case Presentation: A 23 year old Caucasian female with no significant past medical history presented to clinic for evaluation of a recently diagnosed liver mass. The patient had previously been seen in the Neurosurgery clinic for complaints of numbness and tingling sensations in her bilateral lower extremities from her hips down. An MRI of the [...]

Case Presentation: The patient is a 20-year-old male with no past medical history who presented with a 6 day history of 6/10 constant sharp abdominal pain focused in the right upper quadrant (RUQ). The pain was worsened by eating, and associated with one episode of yellow, non-bloody vomiting. The patient denied any diarrhea, bloody stool, [...]

Case Presentation: A 52-year-old male presented for an evaluation of hematuria. The complete blood count, basic metabolic panel and liver function tests were within normal limits. A CT abdomen and pelvis showed an incidental, 1.5 cm lesion in the right hepatic lobe. Following fine needle aspiration biopsy of the lesion, the tissue demonstrated a slightly [...]

Case Presentation: A 47-year-old male with a history of untreated ulcerative colitis (UC) presented to the emergency department with a two-week history of jaundice, malaise, fatigue, right upper quadrant pain, and tan-colored stools. Vital signs were normal. Physical exam was remarkable for epigastric tenderness, sclera icterus and jaundice. Relevant laboratory findings revealed total bilirubin of [...]

Case Presentation: A 35-year-old female dog groomer with a history of an ovarian cyst presented as a direct admission from the Gastroenterology clinic due to worsening upper abdominal pain and weight loss for 2 months. An abdominal CT obtained two weeks prior showed a large left liver lobe mass measuring 6.3 x 4.6 cm. On [...]

Case Presentation: A 63-year-old male presented with altered mental status of one day duration. The patient’s history was significant for CAD, CKD Stage 3, and a recent whipple procedure for cholangiocarcinoma complicated by abdominal abscess requiring percutaneous drainage and prolonged course of ertapenem (renally dosed). He was admitted to the hospital with encephalopathy after having [...]