38 results
Common Bile Duct Biliary Stone removal on ERCP

Dr. Joaquín Berrueta Mezzera @DrJBerrueta

#Biliary #Stone #removal #extraction #ERCP
Common Bile Duct ... Biliary Stone removal ... on ERCP Dr. ... DrJBerrueta #Biliary ... removal #extraction #ERCP
Approach to Conjugated Hyperbilirubinemia - Differential Diagnosis Algorithm

1. Definition: T.bili elevation + >20% conjugated
2. Obtain RUQ
Differential Diagnosis Algorithm ... US to look for ductal ... MRCP, ERCP, liver ... Differential #Diagnosis #Algorithm
Indications for ERCP
1. Biliary Tract Diseases:
 • Biliary obstruction: Choledocholithiasis, Malignant biliary strictures, Benign biliary strictures
Indications for ERCP ... Biliary Tract Diseases ... pseudocysts), Pancreatic duct ... Therapeutic ERCP ... major papilla #ERCP
Jaundice - Differential Diagnosis Algorithm
Pre-Hepatic - Unconjugated Hyperbilirubinemia
Increased Production
 • Hemolysis
 • Ineffective Erythropoiesis
 • Hematoma
Decreased
Differential Diagnosis Algorithm ... - Usually has Duct ... on Ultrasound Biliary ... Duct Compression ... Cholangiocarcinoma • Primary
Biliary Ascariasis - Balloon Extraction on Endoscopy/ERCP

8 years old patient with acute pancreatitis and a MRCP
Biliary Ascariasis ... Extraction on Endoscopy/ERCP ... image in the bile duct ... we perform an ERCP ... ManearrietaGar #Biliary
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
Primary Biliary ... No extrahepatic biliary ... Drug-induced cholestasis, Primary ... malignancy #Primary ... #Biliary #Cirrhosis
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Differential Diagnosis Algorithm ... — Normal Bile Ducts ... • Common Bile Duct ... Stone • Biliary ... Differential #Diagnosis #Algorithm
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... gradual loss of bile ducts ... inflammation and biliary ... Cholestasis #PBC #Primary ... #Biliary #Cirrhosis
Causes of Increased Amylase (Hyperamylasemia)
Increased serum amylase is not always due to pancreatitis. Here are some
Pancreatitis, Pseudocyst, ERCP ... / Surgery, Biliary ... Mumps, Alcohol, Ductal
Hepatomegaly - Differential Diagnosis Algorithm
Malignant
 • Primary Carcinoma
 • Metastases
 • Lymphoma
 • Leukemia
 • Polycythemia
Differential Diagnosis Algorithm ... Malignant • Primary ... Cholangitis • Primary ... Biliary Cirrhosis ... Differential #Diagnosis #Algorithm