March 22, 2021


Acute Gastrointestinal Bleeding – 02/22/2022  – Lots to review, and curiously, the use of SSRIs has been associated with increased risk for UGI bleeding particularly when used with NSAIDs.

Acute Appendicitis: Efficient Diagnosis and Management-08/15/2022 – Right lower quadrant pain, abdominal rigidity, and periumbilical pain radiating to the right lower quadrant are the best findings that point to a diagnosis of appendicitis.  There are several scoring systems available that help to risk stratify patients.

Acute Pancreatitis  – This comes from the In The Clinic Series.  As expected, the tables are excellent- check out Table 2, differential diagnosis of acute pancreatitis.

Capsule Endoscopy in Gastrointestinal Disease: Evaluation, Diagnosis, and Treatment – 04/20/2022  – Think about this procedure to find the causes of occult gi bleeding in the small bowel.  Can be used to dx celiac disease, Crohn’s disease, small bowel tumors, and NSAID-induced enteropathy

Current Management of Acute Appendicitis: Antibiotics or Surgical Intervention -12/17/2021 – Hear a great review of management controversies in appendicitis cases- The expert is Dr. Ted Pappas from our own Dept of Surgery here at Duke. Some patients can be managed with antibiotic therapy but 50% of these cases require surgery within the ensuing 5 year time period.

Diverticular disease: Rapid evidence review – 09/23/2022  – -A 2019 meta-analysis of 9 randomized controlled studies indicated that in patients with uncomplicated diverticulitis, those treated without antibiotics had shorter hospital stays, and no difference in complication or readmission rates compared to patients who did receive antibiotics.

Avoiding popcorn, nuts, or seeds does not decrease the risk of diverticulitis.

Diverticulitis  – A helpful review from 2018. There is no evidence that patients have to cut out seeds, or nuts, or popcorn. Recall that Asian individuals typically have their pain localized to RLQ as opposed to most other individuals who have pain localized to LLQ.

Evidence-Based Care of Patients with Diverticulitis – 04/04/2022  – A great review hosted by Dr. Centor. Learn about when a CT is needed, or a colonoscopy is indicated after diverticulitis is diagnosed.

Gas, Bloating, and Belching: Approach to Evaluation and Management – 07/09/2021  – A conservative approach is recommended.  “Patients can be reliably diagnosed without exhaustive testing.”

Irritable bowel syndrome  – I think the most valuable part of the article is figure 1, which has a diagnostic algorithm that details a pathway for workup of patients with symptoms that would suggest suspected IBS with symptoms of abdominal pain.