The first article from the December 2016 issue of Annals of B Pod is of a patient that is a male in his late 30s with a past medical history significant for trisomy 21, stage III chronic kidney disease of unspecified etiology, and hypertension who presents to the Emergency Department with emesis and dark stools.  The patient is unable to contribute significantly to his history, but his family relates that two days prior to presentation, the patient experienced two episodes of “coffee ground” emesis according to the patient’s home health nurse. Over the next day, the patient subsequently experienced several episodes of melenic stools. His family also notes that he has seemed feverish, more lethargic, and less active than his baseline.