Introduction: Colitis is a rare but serious gastrointestinal complication associated with taxanebased chemotherapy and the mechanism not well understood. The presented case reports colon ischemia as possible for this side effect. A 57-year-old female acute onset of abdominal pain few episodes bloody diarrhea 5 days. was cramping, sharp, central, nausea anorexia. Formed normal stools changed to loose blood tinged stools. No vomiting, tenesmus, fever, or melena reported. She diagnosed...

Introduction: Bosentan is an endothelin receptor antagonist used for pulmonary arterial hypertension (PAH). Drug-induced liver injury (DILI) 1 of the reported side effects. However, mechanism not well understood. A 56-year-old female with PAH on bosentan from 2 months ago was found to have INR 12.8 in lab work. She started Coumadin weeks prior admission DVT. Inpatient works showed AST: 592, ALT: 194, and Alk-P: 273. Total protein 7.7, albumin 2.6, globulin 5.1, total bilirubin 16.1. also had...

Case: A 38-year-old Hispanic male presented with a 3-day history of abdominal pain radiating to the back, nausea and vomiting. One week prior presentation, his primary care physician had prescribed terbinafine 250 mg orally for 3 weeks Tinea corporis involving left shoulder. The developed 4 days after starting terbinafine. patient denied any recent alcohol use, pancreatitis, trauma or changes in-home medications (Aspirin, prograaf, Lisinopril, prednisone, omeprazole) except Terbinafine. His...

Purpose: A 71-year-old male with a history of kidney transplantation in 1995 on mycophenolate mofetil (MMF) for immunosuppression presented dizziness upon standing and shortness breath exertion. He denied chest pain had no coronary artery disease, asthma or chronic obstructive pulmonary disease. alcohol abuse liver There was aspirin non-steroidal anti-inflammatory drug use. previously attempted colonoscopy 1 year ago inadequate due to poor preparation. While the emergency room, he became...

Introduction: Herpes simplex esophagitis (HSE) usually presents as dysphagia and odynophagia is mostly seen in immunocompromised patient with esophagogastrodeudonoscopy (EGD) showing circumscribed ulcers. Here we describe an interesting case of HSE presenting melena fungating esophageal mass immunocompetent patient. Case Report: A 83 year old woman known hypertension, hyperlipidemia idiopathic thrombocytopenic purpura (ITP) who underwent coronary artery bypass graft (CABG) surgery 9 days...

Purpose: A 50-year-old male nursing home resident with a history of end stage renal disease, on hemodialysis, and HIV/AIDS, presented new abdominal distension, diffuse pain, diarrhea. He denied any sick contacts had no recent antibiotic use. liver disease or cirrhosis. Physical exam revealed moderate-to-severe distension fluid wave shifting dullness, streaks red blood rectal exam. Stool tests confirmed positive Clostridium difficile (C. diff) toxin, he was started oral vancomycin intravenous...

Introduction: Schwann cell hamartomas are rare, benign lesions that have been identified throughout the gastrointestinal (GI) tract. They usually found incidentally in stomach or colon, but rarely esophagus. Herein, we present a case of hamartoma Case Description/Methods: A 59 year old male with history gastroesophageal reflux disease (GERD) and hiatal hernia status post Nissen fundoplication presented to gastroenterology office due recurrence symptoms despite diet modification...

Introduction: A 53-year-old woman with morbid obesity presented dysphagia and vomiting 10 days after laparoscopic vertical sleeve gastrectomy (VSG). She denied similar symptoms prior to surgery. Physical exam was benign well-healing surgical scars. An upper GI x-ray series showed progression of contrast through a narrow, tortuous gastric (GS), forming broad circular “knot” before reaching the distal stomach pouch. EGD revealed narrowing at proximal GS. The tract GS into pouch identified by...

Purpose: A 43-year-old female with a history of Roux-en-Y Gastric Bypass performed 10 years ago presented abdominal pain and lower extremity edema. CT scan showed distended remnant gastric pouch. Upper endoscopy was showing normal esophagus without esophageal varices ulceration at the gastro-jejunal anastomosis. The stomach small portion duodenum were excised for suspected gastro-gastric fistula. Pathology chronic gastritis, duodenitis mucosal reparative changes no Helicobacter pylori...

Introduction: Hepatomegaly is a common finding in patients undergoing bariatric surgery. Steatosis the usual cause of hepatomegaly this population, with 33% morbidly obese showing fatty infiltration majority their hepatocytes. Here, we present an interesting patient where planned procedure had to be aborted due laparoscopic mesenteric mass, which was perceived on pre-operative clinical examination. Case Report: A 44-year-old female body mass index 54 referred for gastric banding....

Purpose: The utilization of vertical sleeve gastrectomy (VSG) for the treatment medically-complicated obesity is rapidly growing world-wide. About 30% all world-wide bariatric procedures are now VSG. Post-operatively after VSG, patients can present with emesis and dysphagia. However there a paucity information about frequency management these obstructive symptoms. aims this study were to examine characteristics response intervention in dysphagia Methods: This retrospective chart review 64...

Purpose: A 57-year-old African-American female presented with acute onset abdominal pain and few episodes of bloody diarrhea for five days. The was cramping, sharp, central more than flank pain, nausea anorexia. Formed normal stools changed to loose, small-volume blood tinge stools. No associated vomiting, tenesmus, fever, melena, or chest reported. Had Red Lobster dinner two nights prior symptom onset, though no other family members had similar symptoms. Two months prior, the patient...

Purpose: Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a serious, potentially fatal skin disorder most commonly caused by drug reactions. It can include ophthalmologic, urogenital, and pulmonary manifestations; however, it rare to find involvement of the GI tract. We present case TEN complicated cricopharyngeal stricture, requiring retrograde upper endoscopy via gastrostomy site with Savary dilatation. Case Report: A 61 year-old male initially presented ED for...

Purpose: Effective sedation is an integral part of endoscopy. Difficult results in inadequate exams, aborted procedures and waste medical resources. HYPOTHESIS: gender, alcohol abuse physical/sexual are predictors difficult to sedate endoscopy patients. Methods: This a prospective cohort study. Patients were enrolled the out-patient clinic. At enrollment each patient answered two questionnaires - Self report version Alcohol Use Disorder Inventory (AUDIT) Drossman questionnaire. Score 10 or...

Purpose: An 85-year-old female presented to the emergency department with complaints of 2-3 months intractable pruritis and generalized fatigue. She denied hyperpigmentation skin, but endorsed dark, tea colored urine. also complained night sweats had unintentional weight loss. pain, nausea or vomiting. Physical exam revealed slightly icteric sclera hepatomegaly, no palpable spleen. The alkaline phosphatase was 1030 unit/L, aspartate aminotransferase - 66 alanine 58 unit/L a total bilirubin...