Clinical Focus

  • Anesthesiology

Academic Appointments

Professional Education

  • Internship: Stanford University Internal Medicine Residency CA
  • Residency: Stanford University Anesthesiology Residency (2023) CA
  • Medical Education: Drexel University College of Medicine (2019) PA

Contact

  • Academic
    cchiu105@stanford.edu
    University - Academic staff Department: Anesthesia Position: Clinical Instructor
  • Clinical (Primary)  Anesthesia Department 300 Pasteur Dr Rm H3580 MC 5640 Stanford, CA 94305 (650) 725-8544 (fax)

Additional Clinical Info

Additional Info

  • Mail Code: 5640

All Publications

  • Cannabinoid hyperemesis and pheochromocytoma hypertensive urgency: a case report. Journal of medical case reports Arendash, J. M., Chiu, C., Wang, J., Mihm, F. 2024; 18 (1): 161

    Abstract

    BACKGROUND: This report presents a case of cannabinoid-induced hyperemesis syndrome causing repeated violent retching in a patient with a large (8cm) adrenal pheochromocytoma resulting in hypertensive urgency.CASE PRESENTATION: A 69-year-old white male patient with a previously diagnosed pheochromocytoma presented to the emergency department with nausea and vomiting and was found to have hypertensive urgency. Computed tomography scan did not show any acute abdominal pathology and history was inconsistent with a gastrointestinal etiology. Patient had a history of daily cannabinoid use for many years and repeated self-limited hyperemesis episodes, and thus a diagnosis of cannabinoid-induced hyperemesis syndrome was made. It was concluded that the likely explanation for the hypertensive urgency was from physical compression of his adrenal tumor during the episodes of retching resulting in a catecholamine surge. The patient was given antiemetics and admitted to the intensive care unit for blood pressure management. Blood pressure was initially controlled with phentolamine and aclevidipine infusion, then transitioned to oral doxazosin and phenoxybenzamine. Hyperemesis and abdominal pain resolved after 24hours, and his blood pressure returned to baseline. The patient was discharged with the recommendation to stop all cannabis use. On follow-up, his blood pressure remained well controlled, and he subsequently underwent adrenalectomy for tumor removal.CONCLUSION: Hyperemesis can cause hypertensive events in patients with pheochromocytoma by increasing abdominal pressure, leading to catecholamine release.

    View details for DOI 10.1186/s13256-024-04497-0

    View details for PubMedID 38500192

  • Arsenic Toxicity From the Ingestion of Terracotta Pottery. The Journal of emergency medicine Chiu, C., Fisk, C. A., Rice, B. T., Garcia, E. C. 2022

    Abstract

    BACKGROUND: Symptomatic arsenic toxicity has not been associated with terracotta pottery despite thousands of years of use in food storage and preparation. We describe a case of chronic arsenic toxicity from undiagnosed pica involving the ingestion of terracotta pots.CASE REPORT: A 49-year-old woman with a history of anemia and abnormal uterine bleeding presented to the Emergency Department complaining of lower extremity pain. She was also noted to have chronic lower extremity paresthesia, constipation, and fatigue. She admitted to ingesting glazed and unglazed terracotta pots for the past 5 years. This unusual craving was thought to be a manifestation of pica in the setting of chronic anemia. The patient was found to have an elevated urinary arsenic concentration of 116 g/24 h. An abdominal radiograph showed opacifications throughout her bowel, and she received whole bowel irrigation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Pica is a common behavior in certain populations. Practicing clinicians should be familiar with the complications of pica, including chronic arsenic toxicity and its associated array of nonspecific symptoms.

    View details for DOI 10.1016/j.jemermed.2022.06.004

    View details for PubMedID 36229316