Mr. Weiser's Confusion
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

Poor Mr. Weiser never left the hospital.

His last day:

  • At 2 AM, his varices began to bleed.
  • Because of his portal hypertension, reduced clotting factors and low platelet count, he exsanguinated before it was obvious what was happening.
Autopsy findings:
  • Advanced micronodular cirrhosis.
  • Splenic hypertrophy.
  • Esophageal varices with evidence of recent hemorrhage.
  • Two liters of fresh and partially digested blood in GI tract.
  • Mild cerebral edema.
  • Moderate coronary and systemic athersclerosis.
  • Caput medusae and spider angiomas of chest.
The take home message.                                         Back
 

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