Dr. Michael Chew @mchew85
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GrepMed Gastroenterology-Hepatology Editor, Academic Hospitalist UC Davis Medical Center Internal Medicine, Yale Gastroenterology Fellow '22
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Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
Causes of Severe ... biliary obstruction ... cholangitis ... #LiverInjury #Severe ... #Acute #Causes
Gallstone Diseases
1. Asymptomatic Stones 75%
2. Biliary Pain 20%
3. Acute Cholecystitis 10%
4. Mirizzi's Syndrome < 0.1%
5. Cholangitis/
Biliary Pain 20% ... Acute Cholecystitis ... Cholangitis/ Pancreatitis ... differential #diagnosis #causes
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Stepwise Diagnosis Algorithm ... dose, duration), Several ... for alternative causes ... cholangitis, Primary ... dechallenge • Acute
Irritable Bowel Syndrome (IBS) - Pathophysiology, Diagnosis and Management Algorithm
Risk factors: Previous acute enteric infection, Female
and Management Algorithm ... factors: Previous acute ... Younger age, Other functional ... common: Food, Acute ... Menses - More severe
Abnormal liver function tests algorithm.
 This figure details the initial response to abnormal liver blood tests.
Abnormal liver function ... tests algorithm ... indicate the initial evaluation ... history alongside evaluation ... include extrahepatic biliary
Rome IV Criteria for diagnosing Functional Abdominal Pain Disorders (FAPD)
Irritable bowel syndrome
The criteria must be fulfilled
After appropriate evaluation ... After appropriate evaluation ... episodes of intense, acute ... should be the most severe ... following: anorexia, nausea