Gastroenterology
- Serial serum lipase testing after the initial diagnostic workup for inpatients with acute pancreatitis: What is the evidence?
Beyond the initial diagnostic workup, the results of serial testing may be misleading, with the potential for adverse effects on patient care and increases in healthcare spending.
- Celiac disease: Who should I test, and how?
First-degree relatives of patients with celiac disease and patients with dermatitis herpetiformis, type 1 diabetes mellitus, and autoimmune thyroid disease are among those for whom testing is advisable.
- Diagnosis and management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome
A review of recommendations from the American Association for the Study of Liver Diseases.
- Fundic gland polyps: Should my patient stop taking PPIs?
Of the 2 types of these polyps, the sporadic type is linked to proton pump inhibitor use, whereas the syndromic type occurs on a background of familial adenomatous polyposis—a key distinction.
- Colovesical fistula in men with chronic urinary tract infection: A diagnostic challenge
Most cases are in older men with diverticular disease, Crohn disease, cancer, or iatrogenic injury. Suspect it especially in these patients with UTI symptoms refractory to conventional treatments.
- Evaluation and management of gastroesophageal reflux disease: A brief look at the updated guidelines
Updated guidelines from the American College of Gastroenterology address the evaluation and management of reflux disease, consequences of long-term PPI therapy, and emerging therapies.
- When should antithrombotic therapy be resumed after gastrointestinal bleeding?
The timing should be individualized after considering factors related to the bleeding event, thromboembolic risk, and patient comorbidities.
- Scaly plaques in a malnourished patient
A markedly low serum zinc level and the characteristic location of the rash in a patient with long-standing alcohol use disorder and cirrhosis led to the correct diagnosis.
- Mucinous ascites: Pseudomyxoma peritonei
A 59-year-old man presented with progressive abdominal distention that limited daily activities and oral intake. The ascitic fluid was markedly viscous and jelly-like.
Cirrhotic coagulopathy: A rebalanced hemostasisCirrhosis affects all 3 phases of coagulation, leading to a delicate new equilibrium, easily disturbed and tipped toward either bleeding or thrombosis by acute events such as infection, renal failure, and invasive procedures.
