Brunner's Gland Hamartoma

Patient was in the ER room when first seen. PT was with her family members and family states that she speaks little English and that she has had abdominal pain for the past day along with bloody stools. Family states that she is on calcium supplements and no other medications. Last oral intake is 24 hours ago. Family states no known past medical history. Pt is in the hospital bed in the fetal position and towards the right side. Patient's airway is clear and breathing is normal. Skin is warm and dry. Patent is AAOx4. Assessment of head, neck, and chest show no signs of deformities. Abdominal area not assessed due to severe pain. Back is without deformity. The upper extremity shows no sign of deformities or trauma. The lower extremity shows

This patient presented to the emergency department (ED) with pain in his upper right quadrant and flank. He reported experiencing abdominal distention

Upon inspection the contour of the patients abdomen was rounded, symmetric, color appropriate to genetic background, striae present, 6 to 8 round bruises from subcutaneous injections. No apparent pulsations, masses, lesions, rashes, wounds, ascites, scars, or hernias present. Auscultated bowel sounds in all four quadrants; hyperactive sounds heard in lower right quadrant, hyperactive sounds heard in upper right quadrant, normoactive bowel sounds in upper left quadrant, and hyperactive bowel sounds heard in lower left quadrant. Auscultated the aorta, renal arteries, and iliac arteries for vascular sounds, no bruits heard. Lightly palpated the abdomen in all four quadrants, patient felt tenderness on bruised areas, no masses present, abdomen distended. Percussed the abdomen in all four quadrants noting the predominately tympanic in all four quadrants and minimum dullness. The patient’s last bowel movement was around 0830, loose, with no pain. The patient stated having three to five loose bowel movements daily and that, “several bowel movements a day was common for her.” The patient describe the characteristics of her bowel movement as “watery, stinky, and not a large amount”. No prescription medication related to the abdomen. However, patient takes over the counter medication for frequent bowel movements at home. No surgeries related to the abdomen. No laboratory data related to the

Patient History: my patient is a 79 y/o female. She weighs 71.7 kg and is 165.1 cm tall. She has a history of colon carcinoma and hypertension. She has had a previous cholecystectomy, appendectomy, and removal of a uterine polyp. She has no history of bleeding disorders. She was a smoker, but quit 30 years ago. She smoked a half pack per day for 10 years; rare alcohol use. She is status post right-hemicolectomy. She is allergic to penicillin.

reported that her abdominal discomfort started about eight days ago, after eating Chinese food. She described the discomfort or pain as “ aching and it comes and goes ” and it is located in the right lower abdomen, which is aggravated after attempting to drink fluids of even food. She denies taking alcohol nor illicit drugs. She also denies having any fever or chills in the past eight days. No allergies to medication, as well as to the food, was disclosed.

The patient is an 84-year-old female who did stop her iron supplement, which she was taking for a history of iron deficiency anemia thought related to a Mallory-Weiss tear, which was seen on an EGD done in February 2015. Her hemoglobin and hematocrit had been stable. Because of her symptoms, I did ask her to stop the iron supplement. She does tell me her abdominal pain, increased stooling did go away, since that time, although, she does state today that several weeks ago she did have one further episode of it, but none since that time.

Mr. Louis is a 53 year old male with a history of GERD, diabetes, coronary disease, hyperlipidemia, Diabetes type 2 who presents to the clinic with multiple complaints. First, he is complaining of abdominal pain for the past 2 weeks that has been persistent. He came on a sick a call 2 days ago and he was told to stop taking aspirin because it may have irritated his stomach, but he has not seen any improvement. He rates pain 2/10 and 6/10 when it is worse. He describes the pain as a sharp and burning pain that is aggravated with bending, eating and laying down. He has not taken any medication for this pain. He says he has history of H pylori which he was treated in the past. He is also complaining weight loss and diarrhea for the past couple months.

A review of her medical records indicates that she has a positive occult stool. Her HGB is 7.9 where as her previous HGB was 8.2. She is schedule to follow up with a GI specialist. She suffers from poorly controlled hypertension, poorly controlled bilateral leg edema- she refused to elevate her legs. She also suffers from type 2 DM which is controlled with medication.

Twelve-year-old Hispanic male D.C. presented to Advocate Illinois Masonic Medical Center Emergency Department the morning of May 14, 2015, accompanied by his mother, for complaints of abdominal pain and vomiting that began that morning at 0100. While in the ED, D.C. complained of abdominal pain which he rated ten out of ten, so he was given a GI cocktail with Pepto-Bismol, as well as morphine for pain and Zofran for nausea, and his pain decreased to seven out of ten. Due to D.C.’s complaints of abdominal pain, which included his right lower quadrant, the ED physician caring for him ordered an ultrasound of his appendix. This ultrasound was non-diagnostic, as D.C.’s appendix was not visualized. Because he had a clinical

This 72-year-old white male with progressive microscopic iron deficiency anemia on whom I asked to consult on. The patient is asymptomatic from the GI perspective. He has a history of reflux but this is controlled with omeprazole. There is no abdominal pain, change in bowel habits, weight loss or visible blood per rectum. He has mental forgetfulness and is not a good historian. He also has an active right inguinal hernia that is undergoing evaluation for possible hernia repair.

The patient is on a gluten free diet due to Celiac disease. She is takes a daily vitamin, melatonin and a calcium supplement. She is also on birth control. The patient has a history of recurrent ear infections. The patient was last hospitalized at the age of eight after falling off her bike and passing out. She fractured her ankle as a child. There is a family history of Celiac disease and Parkinson’s disease. She participates in physical exercise by going to swim practice five times a week. The patient does not use tobacco. The patient dislocated her finger and complained of pain at a 3 out 10. There are no concerning moles. Patient’s buccal mucosa is a normal pink color and moist, no signs of lesions in mouth or on tongue. Her uvula is

On admission, the body temperature was 39ºC. Physical examination revealed an ill-appearing well-developed girl with mild pallor, and anicteric sclera. The patient had right upper quadrant abdominal tenderness with no distension or hepatomegaly. Relevant laboratory data included white blood cell count of 13.780/μL with 78% neutrophils; hemoglobin, 10.9 g/dL and C-reactive protein was 325 mg/L. Liver function tests, blood urea nitrogen and electrolytes were within reference ranges. Chest radiograph was normal.

[Name] has a history of many endoscopies. Remote EGD showed antral gastritis, but more recent EGDs were negative for remarkable findings. Colonoscopy showed diverticulosis. She has no history of heart disease or hypertension. Medical history was essentially benign, except for cataracts, and recent cataract history.

Choice “E” is the best answer. This patient has a classic presentation for celiac disease. The classic signs of this disease include diarrhea and weight loss from malabsorption. About one-third of people diagnosed with celiac disease experience diarrhea, and about half have weight loss. In addition to digestive problems, other signs and symptoms of celiac disease include: anemia, usually resulting from iron deficiency, loss of bone density (osteoporosis) or softening of bone (osteomalacia), itchy, blistery skin rash (dermatitis herpetiformis), damage to dental enamel and fatigue. Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a chronic autoimmune disorder of the digestive tract that results in an inability to

Colonoscopy lead to the discovery of diverticula in the colon. It is suspected that they ruptured and lead to on and off, self-resolving gastrointestinal bleed. Which would account for the patient’s dark stools, decreased H&H, nausea, and weakness.