recent articles

EM Cases

EM Cases: Liver Emergencies

We clear up the confusing balance between thrombosis and bleeding in liver patients, the elusive diagnosis of portal vein thrombosis, spontaneous bacterial peritonitis diagnosis and treatment and some tips and tricks on paracentesis

em@3am

EM@3AM: Jaundice in Adults

A 53-year-old male presents with nausea/vomiting and complains of turning “yellow”. He denies abdominal pain, fever, alcohol use, or acetaminophen intake. His vital signs are normal, and exam reveals icteric sclerae, jaundice of his face and chest, and hepatomegaly. He has no tenderness to abdominal palpation. What’s going on, and what’s your next step in evaluation and treatment?

practice updates

Chronic Liver Disease and Hemostasis

Patients with chronic liver disease typically have elevated INRs and thromocytopenia. Thus, clinicians may believe that blood clots are not possible in this patient group. This is a brief review of hemostasis in liver disease and why blood clots can occur even with low platelet counts and elevated INRs.