Daily Archives: November 2, 2017

Question: A 74-year-old vegetarian woman with a medical history significant for severe nonischemic dilated cardiomyopathy, chronic obstructive pulmonary disease, stage IV chronic kidney disease, hypertension, atrial fibrillation on chronic warfarin, and right-sided breast cancer treated with mastectomy >20 years ago, presented for evaluation of fatigue and a 16-year history of iron deficiency anemia. History was notable for an absence of melena, hematemesis, and bright red blood per rectum. Six years prior, she had undergone an upper endoscopy, which identified a Dieulafoy lesion that was treated with cauterization. Continue reading →

Question: A 50-year-old woman was referred for screening colonoscopy during small bowel transplant evaluation. One year ago, she developed acute mesenteric ischemia from superior mesenteric artery thrombosis. She required resection of a major portion o… Continue reading →

Question: A 65-year-old man with a significant past medical history of peripheral vascular disease requiring aortofemoral bypass graft placement in 2009 owing to severe symptoms. Since the surgery in 2009 there had not been any complications involving … Continue reading →

Question: A 58-year-old woman with a history of ulcerative colitis in clinical remission was referred for endosonographic evaluation of a periduodenal mass. She developed abdominal pain in the right upper quadrant and lost 15 lbs over the preceding 3 months. She denied jaundice. Laboratory studies were remarkable for an elevated alkaline phosphatase (ALP) of >1000 U/L (normal range, 38–126) without elevation of aminotransferases or bilirubin. She had no history of cholelithiasis or pancreatitis, and no family history of pancreatic cancer. Continue reading →