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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hepatology diagnosis management cirrhosis algorithm gastroenterology pbc primary differential ercp causes liver treatment acute anatomy cholangiogram endoscopy indications sbp abnormal
Antibiotic Prophylaxis for Endoscopy (ASGE 2015) Give Antibiotics: - PEG tube placement (or PEG-J)
Antibiotic Prophylaxis ... 2015) Give Antibiotics ... mediastinal cysts - Biliary ... Do Not Give Antibiotics ... GI tract) - Biliary
Causes of Severe Acute Liver Injury - Ichemic hepatitis - Acute biliary obstruction - Drug-Induced liver
hepatitis - Acute biliary ... Hemochromatosis - Primary biliary
Spontaneous Bacterial Peritonitis (SBP) - Diagnosis and Management Ascites PMN > 250/mm3 ? Nosocomial or hospital acquired. Recent
Recent exposure to antibiotics ... after empirical antibiotic ... Short-term (< 7 days) antibiotic
Primary Biliary Cirrhosis - Pathophysiology Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish Epigentics Risk
Primary Biliary ... inflammation and biliary ... #PBC #Primary #Biliary
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%
Primary Biliary Cirrhosis - Diagnosis Algorithm Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort Signs: Jaundice, Xanthelasmata, Hepatomegaly Associated history:
Primary Biliary ... #PBC #Primary #Biliary
Difficult Selective Biliary Cannulation (SBC) Factors associated with difficult SBC: - SMALL PAPILLA: can be difficult to
Difficult Selective Biliary ... site - OTHERS: biliary ... #Selective #Biliary
Antibiotic Therapy for Spontaneous Bacterial Peritonitis (SBP) - Standard therapy - Uncomplicated SBp• - Nosocomial SBP
Antibiotic Therapy ... SpontaneousBacterialPeritonitis #Antibiotic
Common Etiologies of Cirrhosis Inflammation - Hepatitis B (15 percent) - Hepatitis C (47 percent) - Schistosomiasis
congenital - Primary biliary
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 Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm DILI suspicion Features toxic aetiology: Skin involvement, Kidney injury,
Benign/malignant biliary ... obstruction, Primary biliary
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