GI

We’re back with Part 2 on upper GI bleeding.  Today we cover endoscopy, other interventions for bleeding cessation, intubation, and risk scores.

Today we have Part 1 on upper GI bleeding, including background, NG tube lavage, blood product transfusion, proton pump inhibitors, prokinetic agents, somatostatin analogues, and antibiotics. 

An 18-year-old female presents to the ED for abdominal pain. The pain began the day prior in the “middle of her stomach,” but is now “lower to the right” and associated with rigors and anorexia. She denies new sexual partners, dysuria, or vaginal discharge, and her last menses was 1 week prior. Triage Vital Signs: BP 109/69, HR 115, T 102.4°F Oral, RR 21, SpO2 99% on room air. She appears uncomfortable but with no acute distress. Her abdomen is soft. She has tenderness to palpation at McBurney’s point, tenderness in the right lower quadrant when palpating the left; evidence of involuntary guarding. What’s the next step in your evaluation and treatment?

How can you optimize your use of POCUS for the gallbladder?

Today the emDOCs cast covers the controversy of antibiotics in uncomplicated diverticulitis.

Today on the emDOCs cast we discuss the ED evaluation of suspected diverticulitis: history, exam, labs, and imaging.

A 75-year-old male with 4 days of abdominal distention, constipation, and decreased PO intake due to nausea. He reports that his symptoms are worse after eating or drinking and that he is able to pass gas but has not had a bowel movement in the past 4 days.  On initial presentation to the ED, he appears anicteric while his abdomen is soft, non-tender, but massively distended asymmetrically with no bowel sounds heard on auscultation. What is the most likely diagnosis?

The emDOCs Podcast looks at esophageal perforation and rupture in this week’s podcast.