A 41 year-old lady, with no relevant medical or family history, presented with sharp right flank discomfort for 2 days and weight loss of 3 kilograms over 1 month. Aside from mild right flank tenderness, no other abnormality was noted on a multisystem clinical examination. She had normal leucocyte, hemoglobin, and liver function levels, a […]
Category: #FGCaseofthemonth
Unusual findings in a Patient Presenting with Right Upper Quadrant Pain
A 69 year old gentleman presented to the ED with a 1 day history of right upper quadrant abdominal pain. He described the pain as cramping in nature radiating to his lower abdomen. He denied any history of trauma but did report a week’s history of productive cough and shortness of breath. He had a […]
A disappearing lumen filling colonic lesion.
A 34 year old man was admitted to hospital with a history of progressively worsening abdominal pain associated with loss of weight. Clinical abdominal exam elicited left iliac fossa pain, but was otherwise normal. Blood tests were unremarkable. A CT KUB at presentation for suspected renal colic was performed and demonstrated a 5cm lesion in […]
Yellowish lesion in the colon
An 82-year-old woman with a history of eosinophilic granulomatosis with polyangiitis treated with 4 mg/day prednisolone underwent a colonoscopy because of a positive fecal occult blood test. This revealed a 2-mm slightly elevated yellowish lesion in the transverse colon (figure 1). Narrow-band imaging showed intact pits of the colonic mucosa (figure 2). Physical examination was […]
An unusual case of dysphagia?
A 16 year-old girl was referred to our paediatric department due to intermittent dysphagia during six months. Occasionally, she needed to induce vomit to dispose of stuck food. She reported no odynophagia, no gastroesophageal reflux symptoms, no abdominal or retrosternal pain, and no changes to defecation patterns. The patient was otherwise healthy and average weight […]
A blushing ulcer?
An elderly lady was admitted to hospital following recurrent episodes of malaena. She had an oesophagoduodenoscopy which revealed a large bleeding gastric ulcer (50mm) near the lesser curvature of the stomach (Forrest III). (Figure 1). The vessel was clipped and spray applied with haemospray. She had a repeat CT angiogram the next day. (Figure 2). […]
Thoracic and abdominal pain in a 28-year old woman with a failing kidney transplant
A 28-year old woman with a failing kidney transplant due to rejection (on high dose Prednisolone and Alemtuzumab) presented with increasing right-sided thoracic pain and abdominal discomfort. Physical examination revealed no abnormalities. Laboratory results showed a normal white blood cell count, low serum C-reactive protein, normal level of liver enzymes and electrolytes, an elevated serum […]
When food gets stuck…?
An 86-year-old woman with a background of ischaemic heart disease presented with dysphagia and odynophagia while eating toast for breakfast followed by sudden onset severe sharp retrosternal and epigastric pain radiating to her back and 3 episodes of coffee-ground vomiting. There were no reported episodes of melaena or syncope. She remained haemodynamically stable. Her blood […]
An unusual cause of intestinal failure
A 62 year old man with well controlled type 2 diabetes presented with abdominal symptoms, significant weight loss and night blindness. He was vitamin A deficient, had marked peripheral oedema and a serum albumin of 12g/l, requiring TPN. Stool culture and testing for HIV and TB were negative. Immunoglobulin levels were normal. Computed tomography showed […]
A rare cause of gastric outflow obstruction
A 78-year old lady with a previous history of oesophagectomy for adenocarcinoma, was referred with symptoms of epigastric pain, post-prandial vomiting and weight loss. OGD after a prolonged fast revealed erosions in the gastric conduit (image A) and the impression of external indentation at the antrum but no stenoses. Biopsies revealed chronic inflammation with no […]