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Chylous Ascites: An Unusual Complication of Necrotizing Pancreatitis

To the Editor: A 59-year-old woman with hypertension presented to the emergency department with abdominal pain secondary to gallstone pancreatitis. She had no history of liver disease, tuberculosis, or cancer. She was febrile to 38.9°C (102°F), blood pressure 49/29 mm Hg, heart rate 124 beats per minute, respiratory rate 31 breaths per minute, and normal […]

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Deadly Diarrhea: The Clever Disguise of Aortic Dissection

  Aortic dissection is one of the great imitators that can present in many ways clinically, depending on the portion of the aorta undergoing dissection.1 Therefore, it is of utmost importance to discuss the variety of presentations, including those that are rare, so as not to miss this potentially fatal diagnosis. Our case is important because […]

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Presumptive Lupus Enteritis

A 22-year-old student of engineering presented with a 2-week history of facial puffiness and pedal edema. Investigations revealed anemia, lymphopenia, urinary nephritic sediment, low complements, antinuclear antibodies with a homogenous pattern on immunofluorescence, and high titers of anti–double-stranded DNA antibodies. A renal biopsy was performed, and the results were uneventful. It confirmed class 4 lupus […]

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The Impact of Aging and Medical Status on Dysgeusia

Disorders of taste and smell can cause an aversion to food in a sick patient and therefore affect his/her ability to maintain optimal nutrition. This can lead to a reduced level of strength, muscle mass, function, and quality of life. Additionally, reduced ability to differentiate between various intensities or concentrations of a tastant can result […]

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A Rare Cause of Large Bowel Obstruction

    A 64-year-old man presented with abdominal distension, pain, and vomiting for 5 days. Computed tomography scan of the abdomen showed dilated small intestine and colon, air in the biliary tree, and a calcified mass in the sigmoid colon. Colonoscopy showed a large impacted stone in the sigmoid colon. This was likely a migrated […]

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