Archive for category: Gastroenterology

REBEL Cast Ep 48: Octreotide and Somatostatin for Undifferentiated Upper Gastrointestinal Bleed

13 Apr
April 13, 2018

Recently I was asked to speak at the Texas College of Emergency Physicians (TCEP) conference April 2018.  The particulars of this session were, five, 10 minute lectures on new indications for old drugs.  My topic was the use of octreotide and somatostatin for undifferentiated upper gastrointestinal bleeding.  This is a particular topic I have been […]

Spontaneous Bacterial Peritonitis

16 Nov
November 16, 2017

Definition: Acute infection of the ascitic fluid in a patient with liver disease without another source of infection Epidemiology: (Runyon 1988, Runyon 1988, Borzio 2001) Incidence 10-25% risk of at least one episode per year 20% risk in those with ascites admitted to the hospital Historically, mortality ~ 50%

Acute Pancreatitis

12 Oct
October 12, 2017

Acute Pancreatitis Background: Definition: Acute inflammatory process of the pancreas; a retroperitoneal organ with endocrine and exocrine function. Epidimiology (Rosen’s 2018) US Incidence: 5 – 40/100,000 Mortality: 4-7% Progression to severe disease: 10-15% of cases (mortality in this subset 20-50%) Etiology: Alcohol (~ 35% of cases) Gallstones (~ 45% of cases) Medications/toxins Hypertriglyceridemia Non-gallstone Obstruction […]

Button Battery Ingestion

04 Sep
September 4, 2017

Button Batteries: Small, disc shaped battery cells which are designed for use in small electronic devices. Common sources are kids toys, watches, calculators and hearing aids. Most batteries use lithium as a power source Button Battery Ingestion Danger: Contact with mucosal surfaces (oropharynx, esophagus, nasal passage) results in transmission of current Current transmission causes chemical […]

Should You Give Albumin in Spontaneous Bacterial Peritonitis (SBP)?

05 Jun
June 5, 2017

The Background: Nearly 50% of patients in the U.S. with cirrhotic liver disease develop ascites over a 10-year period of observation, placing them at risk for developing spontaneous bacterial peritonitis (SBP) (Runyon 2012). It is estimated that 12-25% of patients with ascites in the ED will have spontaneous bacterial peritonitis (SBP) but the classic triad of […]