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This patient had distended umbilical veins (caput medusae) and chylous ascites due to malignancy (metastatic pancreatic NET). Don't forget to check ascitic triglycerides and cytology + imaging if you see this milky colour.
Infographic: @NEJM
Case:https://proceedings.med.ucla.edu/wp-content/uploads/2019/06/Lazarus-A190422ML-BLM-edited.pdf
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Villager from India presents with chronic diarrhoea and these findings. What’s the diagnosis?
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Patient presenting with abdominal distension and this ascitic fluid sample. What’s the diagnosis?
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Appearance of the liver during laparoscopy in a patient with chronic abdominal pain. What’s the diagnosis?
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X-ray of a patient with chronic joint pains, skin hyperpigmentation, raised ALT and new onset diabetes. What’s the diagnosis?
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Over the scope clips (OTSCs) are mounted on the end of an endoscope to stop GI bleeding in high risk ulcers. Here is a one-minute demonstration of how they work
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Beautiful demonstration of the state-of-the-art Fuji colonoscope with computer-aided diagnosis (CADx) and optical ruler
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Should we still be doing Sengstaken tubes in 2023 if we can’t control bleeding oesophageal varices?
Panel answer: Danis stent is preferable, or perhaps even use a Hemostatic powder to temporarise bleeding before TIPSS
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The Bougie Cap can be attached to the end of an endoscope for the dilatation (bougienage) of oesophageal strictures
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View of the stomach in a patient with anaemia and low B12. What’s the diagnosis?
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Patient presenting with chronic diarrhoea and itch. What’s the diagnosis?
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3 months ago, I wrote to a vicar to expedite the marriage of a patient with incurable liver cancer. The couple were in their 70s and were childhood sweethearts. Today, I received the photos from their wedding day - it really is a privilege to be doing this job.T_T
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Bonus points for this very respectable differential - this is a desquamative rash of the hands and feet with is typically associated with reactive arthritis
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This patient had pustulosis of the hands and acne on their back. The joint pains were actually sternoclavicular pain from hyperostosis and osteitis. In patients with IBD, this points towards enteropathic SAPHO
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Patient with IBD presents with joint pains and these skin problems. What’s the diagnosis?
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Examination findings of a patient with alcohol dependence and high triglycerides. What’s the diagnosis?
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Patient admitted with diarrhoea and weight loss is noticed to have this rash from daily blood tests. What’s the diagnosis?
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