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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Cholangiogram Biliary Anatomy on ERCP

#Cholangiogram #Biliary #Anatomy #hepatology #ercp
Cholangiogram Biliary ... Anatomy on ERCP #Cholangiogram ... #Biliary #Anatomy
Difficult Selective Biliary Cannulation (SBC)
Factors associated with difficult SBC:
 - SMALL PAPILLA: can be difficult to
Difficult Selective Biliary ... Cannulation (SBC ... site - OTHERS: biliary ... #Selective #Biliary ... #Cannulation #SBC
How a cholangiogram corresponds to liver segments
 - Numbers indicate drained hepatic segments
 - Right anterior
How a cholangiogram ... lateral course #cholangiogram ... #anatomy #Biliary
Causes of Severe Acute Liver Injury
 - Ichemic hepatitis
 - Acute biliary obstruction
 - Drug-Induced liver
hepatitis - Acute biliary ... Hemochromatosis - Primary biliary
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
Common Etiologies of Cirrhosis

Inflammation

 - Hepatitis B (15 percent)

 - Hepatitis C (47 percent)

 - Schistosomiasis
congenital - Primary biliary
Common Bile Duct Biliary Stone removal on ERCP

Dr. Joaquín Berrueta Mezzera @DrJBerrueta

#Biliary #Stone #removal #extraction #ERCP
Common Bile Duct Biliary ... DrJBerrueta #Biliary
Drug Induced Liver Injury (DILI) - Stepwise Diagnosis Algorithm
DILI suspicion
Features toxic aetiology: Skin involvement, Kidney injury,
Benign/malignant biliary ... obstruction, Primary biliary