{"ops":[{"insert":"A 55 year old man complains of multiple episodes of melena and intermittent abdominal pain over the last 2 weeks.\n\nHe is a heavy drinker, and was diagnosed with alcohol-related chronic pancreatitis 2 years ago. He is not on any medications currently.\n\nHis medical, surgical and family histories are otherwise unremarkable. He does not smoke, and denies recreational drug use.\n\nA full blood count is significant for a hemoglobin of 8.5 g\/dL and hematocrit of 26%.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-S-037_en.png"}},{"insert":"\n"}]}
2
Investigate
Upper GI Endoscopy
{"ops":[{"insert":"There are grade 1 esophageal varices, with no evidence of bleeding. No gastric or duodenal ulcers are present. Fresh blood is seen oozing from the ampulla of Vater.\n"}]}
Colonoscopy
{"ops":[{"insert":"colonoscopy reveals no abnormalities.\n"}]}