Case Presentation: Acute cholecystitis is a very common disease, suspected by the patient’s history and physical examination, confirmed by ultrasonographic imaging, and supported by lab findings suggestive of obstructive jaundice. Our patient had an atypical presentation of cholecystitis, secondary to her atypical anatomy. We present a 61 year old Hispanic woman with past medical history [...]

Case Presentation: Chronic mesenteric ischemia (CMI) is defined as a gradual reduction of perfusion to the bowels. While bowel infarction is the primary concern with CMI, there may be a relationship between CMI and acute acalculous cholecystitis (AAC). We present the case of a 60-year old female with acute onset right upper quadrant (RUQ) abdominal [...]

Case Presentation: A 23-year-old male with granulomatosis with polyangiitis with renal involvement (on azathioprine), stage 4 chronic kidney disease (baseline renal function) presented with fever, weight loss, and new pancytopenia. Broad-spectrum antibiotics were started and a comprehensive infectious work-up was done, including bacterial cultures, viral tests, and fungal serologies. Initial imaging was unremarkable for any [...]

Case Presentation: A 60 year-old male presented with 2 weeks of abdominal pain, anorexia, and constipation. His abdominal pain was crampy, generalized, and progressively worsening in severity. His medical history was significant for alcohol abuse and gallstone pancreatitis. He was abstinent from alcohol for the 2 days preceding presentation secondary to “not feeling well.” He [...]

Case Presentation: A 78 year old female with history of previous cholecystitis s/p cholecystectomy in 1950s complicated by recurrent choledocholithiasis and cholangitis presented with a 1 day history of chills, epigastric abdominal pain, nausea and vomiting. Patient had recurrent episodes almost yearly, characterized by these symptoms. Similar to prior episodes, labs were indicative of biliary [...]

Case Presentation: 70 year old male admitted for a complicated UTI was placed on piperacillin / tazobactam empirically and subsequently developed abdominal distension and small bowel obstruction. He was admitted to the ICU for fulminant colitis secondary to severe Clostridium Difficile with concern for toxic megacolon. Labs showed a WBC of 34 along with an [...]

Case Presentation: Sepsis is a primary cause of death in nearly 23.5% of chronic heart failure patients. The relationship between acute cholecystitis and cardiovascular disease is vague but there have been few studies suggesting cholecystocardiac link. Here we describe a similar case that presented as pulmonary edema and myocardial ischemia.81-year-old male with past medical history [...]

Case Presentation: An 18 years old female with no significant medical history was initially admitted to an outside hospital for urinary tract infection with sepsis. She subsequently developed abdominal pain and elevated liver enzymes prompting transfer to our institution. Physical examination consistent with right upper quadrant pain but remainder was unremarkable. Laboratory testing revealed a [...]

Case Presentation: A 79-year-old male with a history of coronary artery disease status post coronary artery bypass surgery, atrial fibrillation, osteoporosis with vertebral compression fractures presented to the ED for severe right flank spasms. He was recently admitted and discharged just 3 days prior for similar complaints which were attributed to thoracolumbar compression fractures. He [...]

Case Presentation: A 62-year-old female presented with a two-week history of right upper quadrant abdominal pain radiating to the back. Her pain was described as sharp and intermittent and associated with subjective fever, nausea, vomiting, headache, and dizziness. On examination, the patient was hypertensive but afebrile. Abdominal tenderness was noted in the right upper quadrant [...]