IBD

EM@3AM: Inflammatory Bowel Disease

A 24-year-old male with no past medical history presents with several days of oral ulcers and throat pain. He also notes multiple months of diarrhea and hematochezia. He has lost roughly 30 lbs over the preceding 6 months. He has normal vital signs but appears malnourished, with a weight of 48 kg. He has dry oral mucous membranes, abdomen is diffusely tender, and he has ulcers on the uvula and soft palate. Labs reveal anemia, leukocytosis, electrolyte abnormalities, and elevated inflammatory markers. What is the diagnosis?

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EM@3AM: Inflammatory Bowel Disease

32-year-old male presents to the ED with vomiting and abdominal cramping. He has Crohn’s disease and has been poorly compliant with his medications. His current episode began as right lower abdominal pain 1 week ago with several episodes of watery diarrhea daily. He developed diffuse cramping, nausea and vomiting 2 days ago and has been unable to tolerate oral intake. He has not passed stool or flatus in 2 days. His abdomen is distended with hyperactive, high-pitched bowel sounds, increased tympany to percussion, and diffuse mild tenderness to palpation without rebound or guarding. What is the most likely diagnosis?

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