Gastroenterology Archives - Page 5 of 6 - The Emergency Medical Minute

Gastroenterology

Podcast #301: Biliary Pathology

Author: Don Stader, M.D. Educational Pearls Common pathologies include cholecystitis, choledocholithiasis, and in concerningly ascending cholangitis. Cholecystitis is obstruction at the cystic duct leading to inflammation of gallbladder wall, while choledocholithiasis is a distal obstruction of the biliary tree, and ascending cholangitis is an ascending infection of the biliary tree secondary to obstruction. Risk factors…

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Podcast #289: Cannabinoid Hyperemesis

Author: Dylan Luyten, M.D. Educational Pearls Cannabinoid Hyperemesis syndrome is a relatively new diagnosis that presents with vomiting and abdominal pain without a clear etiology in the setting of daily marijuana use. The pathophysiology is not well-understood well, but may involve cannabinoid receptors in the gut. Treatment is abstinence from marijuana, fluids, dextrose, and antiemetics…

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Podcast #288: Diarrhea

Author: Peter Bakes, M.D. Educational Pearls Chronic diarrhea is defined as 3 or more loose, watery stools lasting more than 2-3 weeks. Look for clues in the history, including  travel (could suggest infectious etiology), antibiotic use (could suggest C. Diff), and family history. Irritable Bowel Disease (Crohn’s/Ulcerative Colitis) is an autoimmune disorder that affects 1.3…

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Podcast #285: C Diff

Author: Aaron Lessen, M.D.  Educational Pearls While C. difficile infections are generally thought of as nosocomial, there is a subset of patients who acquire the infection in the community. One recent study showed that about 10% of patients presenting to the ED with diarrhea and without vomiting had a C. diff infection. Another study found…

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Podcast #239: GERD vs. MI

Author: Dave Rosenberg, M.D. Educational Pearls MI and GERD can present similarly. For example, 47% with angina report increased belching with an anginal attack, and 20% of people with an MI describe symptoms  of indigestion that are relieved by antacids. Overall, GERD is more common in those with CAD, so don’t be “reassured” by GERD…

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Podcast #231: Esophageal Tearing

Author: Jared Scott, M.D. Educational Pearls Boerhaave syndrome (aka effort rupture of the esophagus) accounts for 10% of esophageal ruptures and is usually caused by strain during vomiting episodes. It can also be caused by childbirth, seizure, or prolonged coughing or laughing.   Food and water swallowed after the tear end up in the mediastinum,…

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Podcast #177: Rectal Prolapse

Run Time:  3 minutes Author: Jared Scott M.D. Educational Pearls: The true incidence of rectal prolapse is unknown because patients, understandably, under report. Rectal prolapse is most common in patients between 40-70s, but children generally under the age of 3 can have rectal prolapse as well. Women older than 50 are 6 times more likely…

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Podcast #147: GI Bleed – 1966

Run Time: 6 minutes Author: Chris Holmes M.D. Educational Pearls: There was a 50% mortality rate from upper GI bleeds and 20% of cases were unrecognized. Management: The thought was that every patient had peptic ulcer disease or variceal bleeding. First check for liver disease with the bromosulfophthalein excretion test – does not work for…

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Podcast #115: Clostridium Difficile

Run Time: 2 minutes Author: Aaron Lessen M.D. Educational Pearls: One of the big causes of C. diff infection in patients is antibiotics because they destroy the beneficial bacteria in the intestines, which, allows C. diff to run rampant and lead to infection. Different antibiotics have different likelihoods of leading to a C. diff infection:…

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Podcast #70: Pancreatic Injuries

Run Time: 3 minutes Author: Dr. Brent Levy Educational Pearls: Pancreatic injuries are generally associated with blunt trauma and high velocity causing compression of the pancreas into the spine. 3-5% of intra-abdominal trauma injuries involve the pancreas. CT scans are not very effective in diagnosing a pancreatic injury. A clinical diagnosis usually comes from relating history…

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