Daily Archives: January 3, 2017

Question: A 68-year-old woman, asymptomatic, with no medical history, underwent an abdominal computed tomography scan in a traumatic context. An enhanced series (Figure A) revealed a 4-cm cystic mass with tissue and calcified rim components located und… Continue reading →

Colonoscopy with polypectomy reduces mortality from colorectal cancer.1,2 A small fraction of polyps are >2 cm and termed lateral spreading lesions (LSLs) of the colon.3 These polyps require advanced resection techniques such as endoscopic mucosal resection (EMR) for safe and effective removal. However, colonic EMR is not routinely part of the general endoscopic curriculum available to gastroenterologists upon completion of their training. It requires dedicated training in advanced endoscopic resection techniques, the acquisition of clinical and interpretive skills, and the knowledge and ability to manage complications. Continue reading →

Colonoscopy with polypectomy reduces mortality from colorectal cancer.1,2 A small fraction of polyps are >2 cm and termed lateral spreading lesions (LSLs) of the colon.3 These polyps require advanced resection techniques such as endoscopic mucosal resection (EMR) for safe and effective removal. However, colonic EMR is not routinely part of the general endoscopic curriculum available to gastroenterologists upon completion of their training. It requires dedicated training in advanced endoscopic resection techniques, the acquisition of clinical and interpretive skills, and the knowledge and ability to manage complications. Continue reading →

Question: A boy, 6 months of age and previously healthy, was evaluated for unexplained fever of 2 weeks’ duration. He was ill appearing and had a high white blood cell count (19.5 × 109/L) and C-reactive protein (CRP) of 265 mg/L. The diagnosis of … Continue reading →

Question: A boy, 6 months of age and previously healthy, was evaluated for unexplained fever of 2 weeks’ duration. He was ill appearing and had a high white blood cell count (19.5 × 109/L) and C-reactive protein (CRP) of 265 mg/L. The diagnosis of … Continue reading →

“Mrs. Joe was a very clean housekeeper, but had an exquisite art of making her cleanliness more uncomfortable and unacceptable than dirt itself.”— Charles Dickens, Great Expectations Continue reading →

“Mrs. Joe was a very clean housekeeper, but had an exquisite art of making her cleanliness more uncomfortable and unacceptable than dirt itself.”— Charles Dickens, Great Expectations Continue reading →

Question: A 25-year-old man was admitted to the hospital with complaints of nausea, vomiting and abdominal pain of 2-3 months’ duration. He reported early satiety, poor appetite and weight loss of 20 lbs over 3 months. On examination, he was noted to… Continue reading →

Question: A 25-year-old man was admitted to the hospital with complaints of nausea, vomiting and abdominal pain of 2-3 months’ duration. He reported early satiety, poor appetite and weight loss of 20 lbs over 3 months. On examination, he was noted to… Continue reading →

Question: An 89-year-old man had a painless mass in the right inguinal area for >6 months. Anorexia and unintentional weight loss occurred over the past month. His medical history was unremarkable. Physical examination revealed a fixed, hard, nonpulsatile, nontender, and irreducible lesion in the right groin (Figure A). The abdomen was soft, with no pain, and normal bowel sounds. The supine abdominal radiograph showed a normal bowel gas pattern. Sonogram of right inguinal region disclosed a 62 × 25 × 23-mm, well-circumscribed, heterogeneous, hypoechoic, and vascularized tumor (Figure B, white arrowheads). Continue reading →