- N Engl J Med 2022; 387:738-747
A 48-year-old woman was evaluated for abdominal pain. CT showed numerous liver lesions and lung cysts and nodules; liver biopsy revealed an eosinophilic inflammatory infiltrate. A diagnosis was made.
- N Engl J Med 2022; 387:640-640
An 86-year-old woman presented with acute pain on the right side of her abdomen. Computed tomography revealed a distended gallbladder outside the gallbladder fossa and swirling of the cystic artery and duct.
- N Engl J Med 2022; 387:656-657
Acute hepatitis in children is certainly not new, and it can be worrisome. Successful worldwide vaccination campaigns over the past few decades have led to demonstrable improvements in public health and well-being by reducing the incidence and consequences of two viral causes — hepatitis A and B viruses. Many other...
- N Engl J Med 2022; 387:611-619
From January through April 2022, a total of 44 children with acute hepatitis were referred to a liver-transplantation center in the U.K., and 6 underwent liver transplantation; these numbers were higher than those in previous years.
- N Engl J Med 2022; 387:620-630
A majority of children admitted to a single hospital in late 2021–early 2022 with acute hepatitis of unknown cause tested positive for adenovirus. This report describes the children’s illnesses and outcomes.
- N Engl J Med 2022; 387:452-458
A 63-year-old woman presented with dyspnea and cough. She had been in her usual state of health until 2 days earlier, when myalgias and dyspnea with ambulation developed, followed by a cough productive of green sputum.
- N Engl J Med 2022; 386:1834-1844
A 57-year-old man was evaluated in the gastroenterology clinic because of new ascites. Paracentesis yielded milky-appearing ascitic fluid with a triglyceride level of 797 mg per deciliter. CT revealed multiple hypoenhancing liver lesions. There was a history of eosinophilic gastroenteritis and protein-losing enteropathy. A diagnostic test was performed.
- N Engl J Med 2022; 386:1453-1461
An 80-year-old woman was admitted with pancytopenia. Five weeks earlier, nausea, vomiting, diarrhea, chills, and fever had developed. CT revealed bilateral pelvic masses; examination of a peripheral-blood smear revealed schistocytes, anisocytosis, and a low platelet count. A diagnostic test was performed, and management decisions were made.
- N Engl J Med 2022; 386:e30
A 36-year-old woman presented with acute-onset abdominal pain and subacute constitutional symptoms. Subdiaphragmatic free air was seen on imaging, and she was taken to the operating room, where ileal perforations were seen. Tissue cultures grew Mycobacterium tuberculosis, confirming a diagnosis of intestinal tuberculosis.
- N Engl J Med 2022; 386:1106-1107
Mr. O.’s achalasia had worsened beyond what his body could compensate for. His saliva kept entering his lungs, his oxygen levels dropping dangerously each time. He needed endoscopy, urgently. The problem was that Mr. O. didn’t share our concern. And he wanted to eat.
- N Engl J Med 2022; 386:1071-1079
A 54-year-old woman was evaluated in the emergency department because of abdominal pain, nausea, and vomiting. Computed tomography of the abdomen and pelvis revealed circumferential jejunal-wall thickening. Medical history was notable for episodic swelling of the arms, hands, and feet. Diagnostic tests were performed, and treatment decisions were made.
- N Engl J Med 2022; 386:869-878
Chronic pancreatitis, often associated with alcohol use, smoking, or genetic risk factors, may be complicated by pseudocysts, biliary strictures, pancreatic insufficiency, bone loss, and pancreatic cancer. Aspects of management include structural and nonstructural interventions for pain and treatment with pancreatic-enzyme replacement.
- N Engl J Med 2022; 386:796-798
In this study involving non-Hispanic Black members and non-Hispanic White members of the Kaiser Permanente Northern California health plan from 2000 through 2019, colorectal cancer screening increased markedly among both Black members and White members, and racial disparities in colorectal cancer incidence and mortality were virtually eliminated.
- N Engl J Med 2022; 386:505-507
While facing an ophthalmic cancer diagnosis and treatment of his own, a gastroenterologist refocuses his good eye on his patients, helping them play whatever cards they have been dealt, as his scar is etched in survivor’s guilt.
- N Engl J Med 2022; 386:220-229
A major challenge with the treatment of Clostridioides difficile infection is restoring the antibiotic-associated alterations of bowel flora to a state less hospitable to C. difficile. In this trial, a microbiome-replacement therapy, SER-109, was used to treat patients with recurrent C. difficile infection and...
- N Engl J Med 2022; 386:172-172
A 59-year-old man presented with fatigue and hyperpigmentation on his palms and soles. Physical examination showed a smooth tongue with areas of darkening. Laboratory tests showed pancytopenia, a low vitamin B12 level, and an elevated intrinsic factor antibody level, findings consistent with vitamin B12 deficiency due...
- N Engl J Med 2021; 385:2378-2388
A 76-year-old woman presented with abdominal pain, anorexia, memory impairment, and suicidal ideation. CT of the abdomen and pelvis revealed multiple dilated, fluid-filled loops of small bowel measuring up to 4 cm in diameter, with air–fluid levels and a transition point in the right lower quadrant. The urinary porphyrin levels...
- N Engl J Med 2021; 385:2395-2397
In this randomized trial comparing antibiotic treatment with appendectomy in patients with appendicitis, the percentage of patients in the antibiotics group who later underwent appendectomy was 40% at 1 year and 46% at 2 years and was higher in patients with an appendicolith. Videos present information on treatment options for...
- N Engl J Med 2021; 385:1995-2001
A 50-year-old woman with sarcoidosis presented with pain in the left upper quadrant and hypoxemia. The oxygen saturation was 85% while she was breathing ambient air, and crackles were present in both lungs. Chest radiography revealed consolidations in the middle and lower lobes with diffuse ground-glass opacities. A diagnostic test...