Gastroenterology
- Cutaneous metastasis from gastric carcinoma
The patient presented with asymptomatic nodules and alopecia of the scalp 3 years after treatment for gastric adenocarcinoma.
- Persistent rectal pain leading to diffuse pustules
The authors relate the workup of a 34-year-old patient with a history of syphilis and human immunodeficiency virus.
- Acute left-sided colonic diverticulitis: A surgeon’s perspective on the ACP guidelines
The updated guidelines push for less-aggressive management of uncomplicated diverticulitis in select patients.
- Celiac disease in the ‘nonclassic’ patient
Adherence to a strict gluten-free diet is not easy, and even strict adherence does not guarantee relief of all symptoms. We need to be as certain as possible that trying the diet makes sense—and that is the real challenge.
- 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.