Gastric outlet obstruction (GOO) is a rare diagnosis that can be challenging to make as its symptoms, which include abdominal distention, nausea, and persistent vomiting, often overlap with many other acute abdominal pathologies. Point-of-care ultrasound (POCUS) can help the clinician identify gastric outlet obstruction in patients who present to the emergency department (ED). Sonographic identifiers include a markedly dilated stomach that is filled with both hyper- and hypoechoic contents and may extend into the lower abdomen in the pelvic views.
View Article and Find Full Text PDFThe COVID-19 pandemic poses significant challenges to patients with end-stage kidney disease who receive treatment in outpatient dialysis centers. These patients represent a fragile population that is at higher risk for both infection and transmission. At the start of the pandemic, many suspected COVID-19 dialysis patients were diverted to the emergency department (ED) for testing/treatment, placing a tremendous burden on the ED and inpatient dialysis units.
View Article and Find Full Text PDFCase Rep Gastroenterol
July 2019
A rare presentation of acute pancreatitis is with electrocardiographic (ECG) changes that mimic myocardial ischemia. We present a report of a patient that presented with hemodynamic instability and new ECG changes of ST segment elevations in contiguous leads II, III, and aVF mimicking an inferior wall myocardial infarction. Emergent coronary angiography showed no significant coronary obstruction, but it was followed by a left-sided hemiplegia with radiographic evidence of diffuse embolic stroke.
View Article and Find Full Text PDFIntroduction Although medical students in the United States frequently rotate on a non-resident hospitalist team, there is a paucity of literature on their perceptions regarding such rotation. We sought to assess the perceptions of third-year medical students (M3s) regarding a non-resident hospitalist rotation. Methods We conducted a web-based survey of M3s who had previously rotated on a non-resident hospitalist service.
View Article and Find Full Text PDFImportance: Unregulated drug prices increase cancer therapy costs. After induction chemotherapy, patients with metastatic colon cancer can receive maintenance capecitabine and bevacizumab therapy based on improved progression-free survival, but whether this treatment's cost justifies its benefits has not been evaluated in the United States.
Objective: This study sought to determine the influence of capecitabine and bevacizumab drug prices on cost-effectiveness from a Medicare payer's perspective.