Case scenario A 62-year-old female presented to a hospital complaining of nausea, vomiting, melena and left lower extremity pain. She had a history of liver cirrhosis, peripheral vascular disease, chronic pancreatitis, and gastroesophageal reflux disease (GERD). She reported a 25-pack-year smoking history and a history of chronic alcohol consumption. Furthermore, she was restricted to a pureed diet for the last two years.
Additionally, she had a family history of colon cancer . Physical examination revealed a thin, frail, and malnourished health status. Upon questioning, the patient confirmed dysphagia with repetitive gagging, regurgitation of solid food, and unexpected weight loss from the last five years. Laboratory assessment revealed an elevated level of alkaline phosphatase (356 u/L), aspartate aminotransferase (71 u/L), alanine aminotransferase (122 u/L), and a low level of…
