Virendra A. Parikh, MD

December 01, 2003

A 75-year-old obese woman with subacute-onset dyspnea and lower right posterior chest pain was brought to the emergency department. She had a history of diastolic heart failure, arthritis, and suspected obstructive sleep apnea. The patient was dyspneic at rest.

December 01, 2003

A 73-year-old man with chronic constipation presented to the emergency department with hematochezia. Mild, colicky abdominal pain had begun 3 days earlier; obstipation had been present for 10 days.The patient’s history included a cerebrovascular accident 2 years earlier and Parkinson disease; he was taking anticholinergic drugs.

October 01, 2003

A 74-year-old woman was admitted to the hospital with abdominal pain, weight loss, fatigue, and change in bowel habits of 6 months’ duration. Her hemoglobin level was 7 g/dL; carcinoembryonic antigen, 672 ng/dL.

September 01, 2003

A 48-year-old woman complained of dull, aching abdominal pain and epigastric swelling. She had a 6- to 7-month history of painless swelling that intermittently decreased in size. The patient denied vomiting and nausea.

August 01, 2003

An obese 55-year-old woman had intermittent dysuria and frequent urination for 4 days and fever, abdominal pain, and vomiting for 3 days. Her history included type 1 diabetes mellitus, hypertension, and angina; her medications included insulin, nifedipine, and nitroglycerin.

June 01, 2003

Progressive abdominal distention, nausea, constipation, and mild abdominal pain developed in an 82-year-old woman 5 days after she underwent surgical repair of a left hip fracture. Her medical history was significant for Parkinson disease, type 2 diabetes mellitus, and hypertension.

April 01, 2003

During surgical resection for colon cancer, an 8.5-cm diverticulum was found incidentally in a 70-year-old man. The lesion arose from the antimesenteric surface of the terminal ileum; it was located about 2 ft proximal to the ileocecal junction. Palpation of the diverticulum revealed a hard mass at its tip and a thickened wall at its base.

March 01, 2003

A 26-year-old woman complained of flatus and fecal incontinence of solid stool.One year earlier, she was delivered of a 3.86-kg (8.5-lb) infant; a severe perinealtear was repaired after the birth.

February 01, 2002

A 75-year-old woman had a 1-year history of an anal protrusion, bloodstained mucus discharge, and anal incontinence of flatus and loose stools.