18 results
Primary Sclerosing Cholangitis (PSC) and IBD - IBD Algorithm

Dr. Wade Billings @wabillin

#PSC #IBD #Algorithm #IBDAlgorithm #gastroenterology
(PSC) and IBD - ... IBD Algorithm ... @wabillin #PSC ... #IBD #Algorithm ... #IBDAlgorithm #
The 6 C’s of Primary Sclerosing Cholangitis (PSC)
PSC is a chronic, cholestatic, immune-mediated disease characterized by
(PSC) PSC is a ... have concomitant IBD ... • COLITIS - PSC-IBD ... distinct from IBD ... judicious use of ERCP
Primary sclerosing cholangitis (PSC) - Malignancy Screening and Surveillance Recommendations 

Cholangiocarcinoma 
 - Annual US or
Primary sclerosing cholangitis ... (PSC) - Malignancy ... - Annual US or MRCP ... /- AFP CRC - IBD ... #PSC #Malignancy
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
Differential Diagnosis Algorithm ... Ducts - PBC ... , PSC, Alcoholic ... Ducts - CBD ... Biliary stricture, PSC
Alkaline Phosphatase (ALP) Elevation - Differential Diagnosis Algorithm

ALP:
 - Enzymes that catalyze hydrolysis of organic phosphate
Malignancy Most common ... Bone symptoms - Pain ... Primary biliary Cholangitis ... (PBC) - Other ... Infiltrative diseases - PSC
Proposed Schema for the Management of Pruritus in Primary Biliary Cholangitis (PBC). 

Cholestyramine up to 4g
(PBC). ... Recirculating System; CBD ... , common bile duct ... #PBC #Management ... #Hepatology #Algorithm
Dilated Distal Common Bile Duct on POCUS

Male with RUQ abdominal pain for 2 days.  GB
Pancreas/Distal CBD ... dilated distal CBD ... CBD(6+)(Yikes!) ... ERCP/cholecystectomy ... #BileDuct #CBD
ERCP Management Algorithm for Patient with Symptomatic Choledocholithiasis 

Predictors of choledocholithiasis
Very strong
 - CBD stone on
ERCP Management ... Very strong - CBD ... Clinical Ascending cholangitis ... Strong - Dilated CBD ... with galbladder in
IBD Colonoscopy Surveillance - BSG Guidelines 2019
High Risk - 1 Year
 •  Extensive colitis AND
IBD Colonoscopy ... Stricture or dysplasia in ... last 5yrs • PSC ... affecting <50% of colon ... @drkeithsiau #IBD
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
) Factors associated ... insertion into the BD ... tract of the MPD & CBD ... ST upward (the BD ... #Difficult #ercp