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Diverticulitis is a disease affecting over 70% of Americans over the age of 80. It is defined as an inflammation of an outpouching of the colon, and episodes range in severity from mild pain and leukocytosis to peritonitis and septic shock requiring immediate surgical intervention. Current recommendations are for evaluation of the patient with signs and symptoms of diverticulitis with laboratory studies and CT for risk stratification. Patients that are low risk may qualify for outpatient treatment. Despite recommendations for many years, neither fiber nor probiotics have been shown to have a significant effect on the course of disease, and neither is currently recommended by the AGA.

Diverticulitis is a disease affecting over 70% of Americans over the age of 80. It is defined as an inflammation of an outpouching of the colon and episodes range in severity from mild pain and leukocytosis to peritonitis and septic shock. Clinical assessment alone has limited value in the acute care setting. Current recommendations for the evaluation of the patient with signs and symptoms of diverticulitis include laboratory studies and computed tomography (CT) for diagnosis and risk stratification.

Exaggerated arthropod bite reactions causing hemorrhagic or necrotic bullous lesions can mimic other serious conditions such as cutaneous anthrax, brown recluse spider bite, and tularemia. A 55- year-old, healthy woman presented to the emergency department with a 3.5-centimeter painless, collapsed hemorrhagic bulla at the left costal margin. She was afebrile and had no systemic symptoms. Laboratory evaluation was unremarkable. She was prescribed silver sulfadiazine cream and mupirocin ointment. The area denuded two days later and the lesion completely healed. This case illustrates the broad differential to be considered when evaluating patients with hemorrhagic bullous lesions.

Despite advances in medical management, postpartum hemorrhage (PPH) remains a significant source of morbidity and mortality. Primary PPH occurs in the first 24 h after delivery; secondary PPH occurs from 24 h up to 6 weeks after delivery. Severe postpartum hemorrhage is defined as blood loss greater than 1000 ml associated with clinical evidence for hypovolemia. Etiologies for both primary and secondary PPH have considerable overlap; most common causes are uterine atony, retained placenta, infection, and coagulopathy. First-line treatments for PPH include bimanual uterine compression, examination for and treatment of cervical and vaginal lacerations, and uterotonic medications, including oxytocin, methylergonovine, and prostaglandin analogs. Early blood transfusion should be considered with sustained blood loss and signs of hypovolemic shock; coagulopathy should be screened for and treated when detected. Endocavity balloon tamponade is a bedside procedure to control hemorrhage when first-line treatments fail to stop bleeding. Second-line interventions, which include uterine artery embolization and emergency hysterectomy, have high complication rates, but may be lifesaving when first-line therapy is unsuccessful.