Satish Keshav & Emma Culver 
Gastroenterology 
Clinical Cases Uncovered

Gastroenterology is a critically important specialty in medicine,
encompassing the GI tract and two vital organs – the pancreas and
the liver. Gastroenterology: Clinical Cases Uncovered
includes reference to the new JCHMT curriculum for acute and
internal medicine concerning gastroenterology and hepatology and
presents real-life patient cases and outcomes as seen on the wards
and in exams leading students through a practical approach to
recognize, understand, investigate and manage gastroenterological
and hepatological disorders and conditions.

Following a question-answer approach, with self-assessment MCQs,
EMQs and SAQs, and a ‘refresher’ section on basic science,
Gastroenterology: Clinical Cases Uncovered features
investigations and the treatment options available for patients
with upper and lower GI disorders, liver disease, biliary and
pancreatic disease, and problems of nutrition.

Gastroenterology: Clinical Cases Uncovered is ideal for
medical students, junior doctors on the Foundation Programme, GP
trainees, specialist nurses and nurse practitioners and
gastroenterology trainees on the specialty training programme.

สารบัญ

Preface, vii

How to use this book, viii

List of abbreviations, ix

Part 1 Basics, 1

Basic science, 1

Approach to the patient, 14

Part 2 Cases, 29

Upper gastrointestinal

Case 1 A 61-year-old woman with progressive dysphagia,
29

Case 2 A 52-year-old man with atypical chest pain, 34

Case 3 A 57-year-old woman with upper abdominal
discomfort, 40

Case 4 A 36-year-old man with upper abdominal discomfort
and heartburn, 45

Case 5 A 27-year-old woman with nausea and vomiting,
51

Case 6 A 73-year-old man with haematemesis and melaena,
56

Case 7 A 68-year-old woman with fatigue, weight loss and
altered bowel habit, 63

Lower gastrointestinal

Case 8 A 23-year-old woman with constipation, 69

Case 9 A 24-year-old woman with chronic diarrhoea, 74

Case 10 A 51-year-old woman with acute nausea, vomiting
and diarrhoea, 80

Case 11 A 79-year-old woman with altered bowel habit and
weight loss, 85

Case 12 A 54-year-old man with rectal bleeding, 90

Case 13 A 66-year-old woman with anaemia, 95

Liver disease

Case 14 A 64-year-old man with abnormal liver function
tests, 100

Case 15 A 45-year-old man with acute jaundice, 109

Case 16 A 53-year-old woman with jaundice and abnormal
liver tests, 115

Case 17 A 53-year-old man with abdominal swelling,
120

Case 18 A 36-year-old man who drinks alcohol, 125

Biliary and pancreatic disease

Case 19 A 79-year-old man with right upper quadrant
colicky abdominal discomfort, 131

Case 20 A 19-year-old man with acute abdominal pain,
136

Nutrition

Case 21 A 35-year-old woman with anorexia, 143

Case 22 A 48-year-old man with an increased body mass
index, 148

Functional disorders

Case 23 A 21-year-old student with chronic abdominal
pain, 153

Part 3 Self-assessment, 159

MCQs, 159

EMQs, 162

SAQs, 166

Answers, 167

Further reading, 173

Index of cases by diagnosis, 175

Index, 177

The colour plate section can be found facing p.54.

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Satish Keshav is a Consultant Gastroenterologist and
Honorary Senior Lecturer at the John Radcliffe Hospital
in Oxford.

Emma Culver is a Registrar Gastroenterologist at
the John Radcliffe Hospital in Oxford.