HighlightsFAP is initially managed with genetic testing, followed by yearly colonoscopy from 10 to 40 years of age.Once diagnosed, total proctocolectomy with ileal-J pouch to anal anastomosis is recommended.The ultimate treatment for FAP patients presenting with acute lower GI hemorrhage and hemodynamic compromise is unclear.This is the first literature report of an emergency total proctocolectomy for lower GI hemorrhage in an uninsured patient with FAP in a community hospital.It is essential to monitor the ileo-anal anastomosis with anoscopy.

HighlightsTreatment of achalasia in addition to morbid obesity is multifactorial without a gold standard treatment plan for both.Surgical treatment in the young adult female needs to be thoroughly deliberated due to additional risk and lifestyle factors, such as pregnancy.While Heller myotomy is considered the gold standard treatment for achalasia, a POEM better spares the surgical architecture for a future bariatric surgery.