Type 1 aortic dissection is a catastrophic clinical entity originating from the ascending aorta. Clinical suspicion in patients with epigastric pain, chest pain and gastrointestinal symptoms might be life saving. Aortic dissection and acute mesenteric ischemia might be confusing in diagnosis of patients with epigastric pain, chest pain, gastrointestinal symptoms and high white blood cell count ...

six cases of gastrointestinal duplications with varied manifestations are being presented. case 1 presented with an epigastric mass, case 2 presented with an epigastric mass along with projectile vomiting since birth time, case 3 had severe colicky pain and was admitted as an emergency case, case 4 presented with massive rectal bleeding along with hypovolemic shock, case 5 was admitted for cons...

BACKGROUND Epigastric pain is frequent in Emergency Medicine and remains a challenging situation. Besides benign etiologies such as gastritis or uncomplicated cholelithiasis, it could reveal myocardial infarction or vascular disease. Point-of-care ultrasound (POCUS) could be performed in such situation. CASE PRESENTATION A healthy 66-year-old man with no previous medical history was admitted ...

To the Editor—We read with interest Wong et al’s paper on dilated common bile ducts (CBDs) mimicking choledochal cysts in ketamine abusers.1 On reviewing our database of ketamine abusers from July 2005 to June 2008, we found two similar patients who had episodes of recurrent epigastric pain and were subsequently found to have CBD. The first patient was a 30-year-old man who abused ketamine sinc...

Primary mediastinal embryonal cell carcinomas are aggressive tumors commonly presenting between the ages of 20-50 years with pulmonary symptoms (e.g., cough, chest pain, and hemoptysis), as well as extrapulmonary symptoms due to pressure on adjacent structures. Here we describe a 72-year-old man who remained undiagnosed for a prolonged period of time because of intractable epigastric pain. The ...