The ultimate question however is does initiation of PPIs reduce clinically relevant outcomes (i.e. mortality, rebleeding, need for surgical intervention) in upper gastrointestinal bleeds (UGIB)?
R.E.B.E.L. EM – The Good, The Bad, and The Ugly of Proton Pump Inhibitors in UGIB Read More »
Blood in the vomit.
Blood in the stool.
Blood in the diaper.
How far do I go in my investigation?
What do I really have to worry about?
The differential diagnosis of GI bleeding in children is broad.
PEM Playbook – GI Bleeding in Children Read More »
A 46-year-old female presents to your ED with a complaint of abdominal pain and fullness for several weeks and a family history of “blood clots”. Could this be Budd Chiari syndrome?
Budd Chiari Syndrome: ED Presentation, Evaluation, and Management Read More »
Remember Borchardt’s Triad? This triad includes pain, vomiting, and the inability to pass a nasogastric tube, which is present in up to 70% of patients with gastric volvulus. Read on for more on gastric volvulus.
Gastric Volvulus: ED Presentation, Evaluation, and Management Read More »
Cholangitis is a potentially deadly disease. Before procedures including ERCP, mortality reached 100%. Rapid recognition and treatment are essential, which can decrease mortality to less than 10%. This post discusses updates in evaluation and management of the patient with cholangitis.
Cholangitis: Pearls & Pitfalls Read More »
Cholangitis should be considered in patients with undifferentiated sepsis. Ruling in or out the diagnosis of cholangitis is no longer based on clinical exam alone. The addition of imaging and bloodwork to the clinical exam are much more reliable. Resuscitation, antibiotics and consultation for early biliary decompression are the mainstays of cholangitis treatment.
Cholangitis: Deadly Cause of Right Upper Quadrant Abdominal Pain Read More »
Remember that patient you had with a week of sore throat and fatigue who presented with new left upper abdominal pain? Splenic infarction isn’t such a rare entity in mononucleosis… This post is full of pearls and pitfalls in the diagnosis and management of splenic infarction in mono.
Splenic Infarction in Mononucleosis: Pearls and Pitfalls Read More »
How will you approach this sick, unstable cirrhotic patient? What are some of the complications of patients with cirrhosis and chronic liver disease?
Approach to the Sick Cirrhotic Patient Read More »
We’re grateful to Mathew Miskimon, MD PhD for providing this morbidity and mortality (and improvement!) case from Janus General. Includes a nice discussion at the end on the systemic factors contributing to the outcome.
Mystery Bleed (M&M) Read More »
