Monthly Archives: June 2017

Question: A 42-year-old woman was admitted to our hospital with a 1-year history of right upper abdominal distension and discomfort that had worsened for the past month. She had no history of liver cirrhosis or chronic hepatitis B virus infection. Phys… Continue reading →

Question: A 32-year-old woman with no past medical history presented to our medical center with 2 months of intermittent right upper quadrant pain. The pain started gradually, hurting primarily when lying on her right side. She had limited past medical… Continue reading →

Question: A 73-year-old woman experienced 2 episodes of hematochezia 2 weeks before her admission. She had been treated for mild hypertension, and had a history of cholecystectomy, appendectomy, 2 C-sections, and unspecified pancreatic surgery 17 years… Continue reading →

Question: In the early morning, a 22-year-old member of a fraternity presented at our emergency department with retrosternal pain and dysphagia. He had participated in a beer drinking duel and had drunk about 1.5 L of beer, divided into smaller portion… Continue reading →

Question: A 71-year-old woman with hypertension and dyslipidemia was referred to our hospital because of a high level of carbohydrate antigen (CA) 19-9 of 85 U/mL. She was asymptomatic and had no findings on physical assessment or blood tests, except a… Continue reading →

Question: In April 2015, a 68-year-old woman with refractory inflammatory bowel disease was referred to our hospital for further examination. She had a history of pulmonary tuberculosis. Her symptoms of self-remitting fever, diarrhea, and abdominal pai… Continue reading →

Among patients with large colorectal sessile polyps or laterally spreading lesions, it is important to identify those at risk for submucosal invasive cancer (SMIC). Lesions with overt endoscopic evidence of SMIC are referred for surgery, although those… Continue reading →

We read with interest the article by Elmasry et al.1 Among the 9 patients in whom serum alanine aminotransferase (ALT) levels did not normalize despite a sustained virologic response (SVR) 12 weeks after therapy with direct-acting antiviral (DAA) agen… Continue reading →

Cholecystectomy (CCY) following an episode of choledocholithiasis requiring endoscopic retrograde cholangio-pancreatography (ERCP) with stone extraction reduces recurrent biliary events, compared to expectant management. We studied practice patterns fo… Continue reading →

Proton pump inhibitors (PPI) have been associated with acute kidney injury (AKI) and recent studies suggest that they may be associated with the risk of chronic kidney disease (CKD). Continue reading →