The American Journal of Medicine Blog

A 59-year-old woman with no prior liver disease or portal hypertension presented with an episode of right upper quadrant pain that lasted for 3 hours. The patient had a history of cholelithiasis, which was diagnosed 3 years earlier. She denied any other symptoms. Her social and family history were unremarkable. Assessment Her examination was remarkable […]

A 42-year-old man was admitted to the Johns Hopkins Hospital with right upper quadrant abdominal pain and scleral icterus of 3 weeks duration. The pain was described as aching and cramping in quality that typically occurred after meals. He had no vomiting or diarrhea but did note acholic stools and had more recently developed diffuse […]

A 54-year-old man with history of diabetes mellitus and acute necrotizing pancreatitis was admitted with acute abdominal pain. A computed tomography scan of the abdomen revealed findings consistent with acute pancreatitis. Initial laboratory analysis was unremarkable except for HbA1c 11.1%, lipase of 2195 U/L, and amylase of 234 U/L. Interestingly, the laboratory reported that the […]

Lupus enteritis is a rare manifestation of systemic lupus erythematous and is considered as a form of visceral vasculitis involving predominantly the jejunum and ileum, with subsequent submucosal edema. Clinical presentation is nonspecific, and main symptoms include focal or diffuse abdominal pain, vomiting, diarrhea, and fever. Even if there is no pathognomonic imaging feature of lupus […]

In November 2014, a 33-year-old man presented to the Chiba University Hospital with a sudden onset of right lower abdominal pain spreading to the right lower back, developing 10 hours after gross bleeding. He had been receiving anti-tumor necrosis factor therapy for 10 years for mild to moderate Crohn’s disease with no fever. On examination, […]

Vague symptoms belied a 59-year-old woman’s dire situation. She presented with a 3-month history of abdominal pain, constipation, and anorexia, accompanied by a 40-pound (18.1 kg) weight loss. Initially she had attempted to manage her symptoms conservatively, but worsening abdominal pain, bloating, and loss of appetite prompted her to seek medical care. The patient denied […]