Prasad Kulkarni, MD

Progressive weakness, confusion, and decreased oral intake preceded hospital admission for this 73-year-old man with a history of Parkinson dementia and resection for esophageal adenocarcinoma. The real problem, seen here, was revealed on a chest x-ray film.

A 56-year-old man presented to the emergency department with a 1-week history of dark-colored urine and acholic stools followed by 3 days of intermittent right upper quadrant abdominal pain and overt jaundice. He had been healthy and did not smoke or drink alcohol. His family history was unremarkable. He recently lost 15 lb and experienced early satiety and intermittent night sweats.