By Abdullah A. Shaikh, Syed M. Hussain, David J. Desilets, Tara M. Catanzano

Scientific scholars and junior medical professionals are an essential component of the healthcare method. On an educational gastroenterology carrier, they typically firstly evaluation the sufferers which are then staffed by means of the consulting health care professional. like every medical specialties, the purchase of clinical wisdom is needed to achieve services. There are a number of assets corresponding to textbooks and evidence-based articles which are to be had for this objective. encouraged from sufferer care, this e-book bargains a clean method of scientific instructing. this can be a varied form of publication. It contains a gamut of instances for which gastroenterologists are in most cases consulted for within the health facility and outpatient surroundings. every one case is gifted from preliminary background and work-up together with imaging (various modalities together with endoscopy), by means of a quick dialogue on administration. Questions are provided to the reader in every one case via a solution. considering that every one case is exclusive, the pertinent educating issues are verified in a question structure in the case narrative. just like real-life situations, this is helping the reader to hold crucial info. Why purchase this booklet? in contrast to directory evidence as so much evaluate books do, educating issues are built-in into real looking medical situations. scientific scholars to residents/registrars in inner drugs, emergency medication, GI drugs, radiology and surgical procedure would receive advantages from this e-book alike. Secondary audiences will contain nurses and normal practitioners who are looking to comprehend the presentation of universal GI instances and linked imaging. furthermore, it may even be almost certainly used as a coaching device a beneficial academic source for senior colleagues who get pleasure from educating. ultimately, this ebook might make an outstanding prerequisite ahead of beginning any gastroenterology rotation.

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CVS Normal S1, S2. No murmurs, rubs, or gallops. RESP Clear to auscultation. ABD Soft and non-tender. No rigidity, guarding, or rebound tenderness. Bowel sounds are present. Rectal examination reveals brown stool. EXT No edema. 34 What blood test(s) will you order? No blood tests are needed. What imaging test will you order? Barium swallow or esophagram. These tests are the same but have different names. What would you advise the patient regarding the test in terms of preparation? Ideally the patient should eat nothing for a few hours prior to the examination.

At the distal third of the esophagus, inferior to the level of the pacemaker lead heading to the right ventricle, contrast is heading in a lateral direction to the right (red arrow). The patient is slightly rotated to the left to place him in an oblique view to demonstrate that contrast is heading in a posterior direction (not shown). The black arrows mark the esophageal wall. This examination would ideally be done in the upright, lateral, and oblique views. This patient is very ill and therefore proper technique could not be utilized.

There is no focal abscess or extraluminal gas. The remainder of the visualized colon is unremarkable. Free fluid is noted within the pelvis and left paracolic gutter. qxd 11-05-2013 00:29 Page 27 Case 9 What is the next step? A surgical consultation will need to be obtained, as this patient has clinical and radiographic findings consistent with acute appendicitis. He will need to be prepared for surgery. Adequate hydration, correction of electrolyte abnormalities, and preoperative antibiotics are key steps prior to surgery.

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