56 results
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
portion, more proximally ... SBC #Difficult #ercp
Approach to Conjugated Hyperbilirubinemia - Differential Diagnosis Algorithm

1. Definition: T.bili elevation + >20% conjugated
2. Obtain RUQ
MRCP, ERCP, liver
Acute Pancreatitis - Diagnosis and Management - GrepMed Handbook

Presentation: 
 • Epigastric abdominal pain (90%, characteristically
HyperCa2+ • Other: ERCP ... complications), MRCP ... Gallstones: Urgent ERCP ... cholangitis, consider ERCP
Liver Flukes on ERCP
Here are liver flukes (Fasciola hepatica) extracted from the bile duct during ERCP
Liver Flukes on ERCP ... bile duct during ERCP ... Liver #Flukes #ERCP ... clinical #EGD #ERCP
ERCP - Obtaining a good Cholangiogram
 • General Tips
 • Patient Positioning
 • Image Capture
 •
ERCP - Obtaining ... @enrrikke #ERCP
ECG of a 32-year-old lady with chest pain. 

Cath showed 100% proximal LAD Occlusion.
twitter.com/EM_RESUS #ProximalLAD
Differentiation between Portal Venous Gas and Pneumobilia #Diagnosis #EM #Rads #Surgery #Differential #Differentiation #HepaticGas #Pneumobilia #PortalVenous
#Venous #Gas #ERCP
The causes of Pancreatitis 
The mnemonic "l Get Smashed" 
is often found to be helpful. 

Idiopathic
Hypothermia ERCP
Chronic Diarrhea - Workup
Osmotic:
 • Consider food diary and trial avoiding certain foods or meds, Consider
Endoscopy (EGD +/- ERCP ... ultrasound, or MRCP
Indications for ERCP
1. Biliary Tract Diseases:
 • Biliary obstruction: Choledocholithiasis, Malignant biliary strictures, Benign biliary strictures
Indications for ERCP ... Therapeutic ERCP ... major papilla #ERCP