Blood clotting in the setting of chronic liver disease is complex and may result in a net prothrombotic or antithrombotic state. Complicating this situation is the lack of accurate lab assays to measure the net thrombotic state in liver disease patients.
Classic symptoms of appendicitis include pain that is initially vague and periumbilical followed by a more localized parietal pain in the right lower quadrant. Only 50% of people present with these classic symptoms; in the other 50%, appendicitis can be difficult to diagnosis.
Hematemesis is the vomiting of fresh (bright red) or altered ("coffee ground") blood. Melena is the production of black, tarry stools and is due to bleeding from the upper gastrointestinal (GI) tract of more than 100 mL of blood.
Many bacteria (e.g., Vibrio cholerae) secrete toxins that inhibit the ability of mucosal enterocytes to absorb NaCl and water and, at the same time, stimulate mucosal secretory activity. Bacteria or…
In the area of a gastric or duodenal peptic ulcer, the mucosa has been attacked by digestive juices to such an extent as to expose the subjacent connective tissue layer (submucosa).
Work-up for lower abdominal pain begins with resuscitation and exclusion of critical diagnoses: AAA (Abdominal Aortic Aneurysm); Mesenteric Ischemia; Perforation; SBO (small bowel obstruction); ectopic pregnancy
Abdominal Compartment Syndrome occurs when elevated intra-abdominal pressure (IAP), or, intra-abdominal hypertension (IAH), leads to new organ dysfunction. The incidence of abdominal compartment syndrome in the ED has not been reported, but in studies of trauma patients, the incidence is between 1% and 14%.
Work-up for upper abdominal pain begins with resuscitation and exclusion of critical diagnoses. Then, through a detailed history and physical, consider all the causes of upper abdominal pain. The differential may then come down to Gallstone etiology vs Gastritis/PUD → will need further imaging based on suspicion (US abdomen)
Upper gastrointestinal bleeding (UGIB) results from a variety of conditions that can vary from annoying to life threatening. The determination of nonvariceal versus variceal bleeding is critical as the tests…
Acute mesenteric ischemia (AMI) occurs when blood flow to the small intestines is not sufficient for normal bowel function. AMI is a high-risk diagnosis that carries an extremely high mortality…